Oral Methergine: It’s Not Just for Postpartum Hemorrhage [30H]

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Abstract

INTRODUCTION:

Abnormal vaginal bleeding has a direct impact on a woman’s quality of life; anemia, fatigue, loss of time from work and the impact on marital relations, and social obligations are a few of the common adverse effects. Methergine® is widely accepted as a front-line medication treatment for primary and secondary post-partum hemorrhage (PPH) and for the treatment of bleeding after first trimester loss. Methergine is commonly used more broadly for bleeding not only associated with pregnancy, delivery, or pregnancy loss or fetal demise, but in a variety of other medical situations most likely to prevent excessive bleeding and the associated symptomatology associated with anemia.

METHODS:

A retrospective review of Humana Claims data base 1/1/2007- 9/30/2016 and ICD-9 codes cross referenced with Methergine® and diagnosis code was conducted.

RESULTS:

The Humana Claims data base consisted of 22.4 million claims (treatment, medical or laboratory). We found 10,952 claims which had used Methergine® as part of their treatment paradigm. 71% (7,796/10,952) were associated with primary or secondary PPH, and 29%(3,156/10,952) were non-Post-Partum Hemorrhage and non-first trimester loss use for hemorrhage prevention or excessive bleeding. The alternative ICD-9 diagnoses that were associated with Methergine® included menstruation, infection, and painful menses/dysmenorrhea.

CONCLUSION:

Methergine® is utilized in the obstetrical bleeding paradigm, given its mechanism of action, efficacy and safety profile. It is commonly prescribed in scenarios of hemorrhage or first trimester loss however up to one third of use may be for other indications. Future research is warranted to further confirm the efficacy and safety in non-obstetrical situations.

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