Postpartum cardiovascular complications after bromocriptine and cocaine use

Article Abstract:

Bromocriptine is an agent used to stop lactation and prevent engorgement in women choosing not to breast feed after delivery. Since there is the potential for bromocriptine to cause heart problems, the Food and Drug Administration does not recommend its use after delivery. A 25-year-old woman with a history of cocaine abuse was diagnosed with pregnancy-induced high blood pressure. After a cesarean section delivery, the patient's blood pressure remained slightly elevated but did not require blood pressure-lowering drugs. The first day after delivery, bromocriptine was given to suppress milk production. On the fifth day after delivery, the patient returned to the emergency room with shortness of breath, high blood pressure and a rapid heart rate. Although bromocriptine is known to lower blood pressure, some investigators have reported cases of increased blood pressure, stroke and heart attack. It is thought that recent or concomitant use of cocaine increased the action of bromocriptine, which resulted in cardiovascular changes. Although the mechanism is not understood, cocaine, which is know to cause increased sensitivity to a neurotransmitter chemical produced in the brain, may play a role in selected patients. It is advised on the basis of this experience that patients with a history of cocaine use not take bromocriptine after delivery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Complications and side effects, Drug therapy, Heart, Postnatal care, Cocaine, Puerperium, Bromocriptine

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The effects of indomethacin and terbutaline on human fetal umbilical artery velocimetry: a randomized, double-blind study

Article Abstract:

The drugs indomethacin and terbutaline do not appear to affect placental impedance of blood flow through the umbilical artery. Indomethacin and terbutaline are taken during pregnancy to prevent preterm labor. Blood flow velocity through the umbilical artery, as measured by the systolic/diastolic ratio, is used to determine placental resistance. Of 41 pregnant women, 15 took indomethacin, 12 took terbutaline and 14 took a placebo. There were no significant differences in systolic/diastolic ratios between the groups taking indomethacin and terbutaline and the group taking placebo. Furthermore, there were no significant differences in the systolic/diastolic ratio before and after treatment within each group.

Indomethacin, Umbilical arteries, Terbutaline

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