Ergometrine administration for post-partum haemorrhage in an undiagnosed pre-eclamptic

We report a case of a parturient who was well antenatally but presented with oliguria following delivery. The possibility of post-partum pre-eclampsia was obscured by simultaneous post-partum haemorrhage. Ergometrine was given and she suffered an eclamptic seizure shortly after. We discuss the diagnostic difficulties presented by simultaneous presentation of post-partum pre-eclampsia and haemorrhage and the likelihood that ergometrine precipitated eclampsia in a patient at risk. While ergometrine is an effective drug for the management of uterine atony, its potential role in precipitating eclampsia must be considered.