oxytocin and Acute-Coronary-Syndrome

Topics: Acute Coronary Syndrome; Cesarean Section; Female; Humans; Oxytocics; Oxytocin; Pregnancy

Postpartum hemorrhage affects 5% of parturients. Its prevention relies mainly on the administration of oxytocin derivatives. Carbetocin is a newly available analogue of oxytocin but has a considerable incidence of side effects.. We report the case of a woman with no cardiovascular risk factors experiencing an acute coronary syndrome with significant electrocardiogram changes perioperatively after a single injection of carbetocin during an emergency Cesarean delivery. Postoperative cardiac enzyme levels and transthoracic echocardiogram results were normal.. A 2012 retrospective analysis of the use of carbetocin in our institution revealed an incidence rate for coronary events of 1/245 (0.34%), a rate similar to the ones reported in previous studies. We discuss the management of patients with angina during a Cesarean delivery as well as the plans to care for these patients in the future.

Topics: Acute Coronary Syndrome; Adult; Cesarean Section; Echocardiography; Female; Humans; Oxytocics; Oxytocin; Pregnancy

Acute coronary syndrome (ACS) during pregnancy and delivery is a rare event that is usually related to prior disease or family history. Factors that contribute to the appearance of ACS during delivery in women with healthy coronary arteries include high doses of drugs to suppress contractions or increase uterine muscle tone and cardiovascular instability of any kind. Clinical and electrocardiographic abnormalities (eg, ST segment depression) that are suggestive of ACS have been reported to occur during cesarean section but without subsequent enzyme or echocardiographic abnormalities.

Topics: Acute Coronary Syndrome; Adult; Analgesia, Epidural; Cesarean Section; Coronary Vasospasm; Female; Fetal Distress; Humans; Intraoperative Complications; Obstetric Labor Complications; Oxytocin; Pregnancy; Ritodrine; Tocolytic Agents