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.