Which finding in a postpartum patient’s history would lead the nurse to withhold Methergine (methylergonovine maleate)?

Which finding in a postpartum patient’s history would lead the nurse to withhold Methergine (methylergonovine maleate)?

• A. Pregnancy induced hypertension.
• B. Placenta previa.
• C. Gestational diabetes.
• D. Postpartum hemorrhage.

Answer: (A)

Methergine works by stimulating the uterus to contract strongly, which helps prevent or control postpartum hemorrhage. At the same time, it causes peripheral vasoconstriction and raises blood pressure. In a patient with pregnancy-induced hypertension, giving Methergine could trigger a dangerous rise in blood pressure and increase the risk of complications like a hypertensive crisis or stroke. That’s why this finding would lead to withholding the drug. Other options don’t carry the same immediate risk in this scenario: gestational diabetes doesn’t contraindicate Methergine, postpartum hemorrhage is an indication for uterotonics rather than a reason to withhold, and placenta previa isn’t a direct contraindication to Methergine in the same way hypertension is.

Methergine works by stimulating the uterus to contract strongly, which helps prevent or control postpartum hemorrhage. At the same time, it causes peripheral vasoconstriction and raises blood pressure. In a patient with pregnancy-induced hypertension, giving Methergine could trigger a dangerous rise in blood pressure and increase the risk of complications like a hypertensive crisis or stroke. That’s why this finding would lead to withholding the drug. Other options don’t carry the same immediate risk in this scenario: gestational diabetes doesn’t contraindicate Methergine, postpartum hemorrhage is an indication for uterotonics rather than a reason to withhold, and placenta previa isn’t a direct contraindication to Methergine in the same way hypertension is.