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B191 Oxytocin for postpartum hemorrhage and associated vasospastic angina: a case report
  1. F Yfantidis1,
  2. E Ganitis1,
  3. T Mania1,
  4. A Fragouli2 and
  5. E Logotheti1
  1. 1General Hospital of Volos, Anesthesia and Pain Management Department, Volos, Greece
  2. 2General Hospital of Volos, Gynecology and Obstetrics Department, Volos, Greece


Background and Aims Oxytocin is a neuropeptide hormone, normally produced by the hypothalamus and released from the posterior pituitary . Synthetic oxytocin is used to stimulate uterine contraction, in labor and in postpartum to control bleeding.

Methods An ASA II, 27-year- old woman was scheduled for un elective caesarian section . From her medical history, she has been diagnosed with an oligosymptomatic infection with covid 19, a month ago and she underwent two caesarian sections in the past.

Results Under spinal anesthesia, a caesarian section was performed with delivery of a live male infant.After placental delivery we administrated 5UI of oxytocin. In the next 2 min the patient complained of headache, chest pain, palpitations and on examination she had hypertension, tachycardia and some ESV’s. No signs of ECG abnormalities (elevation ST, T) were noted.

We sedated the patient and controlled the hypertension with low doses of Trinitrate. In early postoperative period, troponinaemia and disorders of the ECG (depression ST V3-V6, prolonged QT, T elevated), were observed, therefore the patient was moved to the coronary department for evaluation. A cardiac ultrasound revealed a hypokinesia of basic interventricular septum and a mild mitral regurgitation. Next day, her cardiac ultrasound was normal but the troponinaemia persisted for 3 more days. The patient remained asymptomatic thereafter.

Conclusions Vasopressor drugs may provoke similar angina events such as ephedrine, phenylephrine, ergonovine, oxytocin. Close attention to the patients’ symptoms, appropriate cardiac monitoring, and postdelivery cardiac assessment ensures timely recognition and subsequent management. Risk assessment for post covid patients must be included for further investigations .

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