Asthma deaths following ergometrine and syntometrineWilliam FS SellersThe 2017 to 2019 maternal mortality report (MBRRACE-UK) described a death of an asthmatic possibly from air embolism at Caesarean section. What kind of uterine constrictor drug, or if one was used is not described, and because reports are confidential this information is unavailable. Ergometrine was reported to have caused bronchospasm in an asthmatic after delivery by Caesarean section1 and this stimulated a case report from Anaesthetist Professor Selwyn Crawford of a death of an asthmatic patient after receiving ergometrine, although at the time this cause had not been considered.2 To find if ergometrine and syntometrine were involved in any other maternal deaths, the Royal College of Obstetricians and Gynaecology library’s complete collection of triennial reports from 1952 to 2019 was studied. The 1976-1978 Report page 80 describes the death reported by Selwyn Crawford. The 1988-1990 Report has two asthma deaths. Page 71 reports a death of a patient who had concealed her asthma and died following a legal termination at seven weeks gestation from sudden and severe bronchospasm. Whether a uterine constrictor was used is not mentioned. Page 89 describes an asthmatic patient who died after a legal termination at six weeks under general anaesthesia and an injection of 1ml of syntometrine, after which she developed difficulty in breathing and became cyanosed. A tracheal tube was passed but manual ventilation was impossible because of severe bronchospasm. The report goes on to state: “The cause of the acute bronchospasm is not clear.” Ergometrine and syntometrine constrict vascular, uterine, and bronchial smooth muscle and should be avoided in pregnant asthmatics.References.Sellers WFS, Long DR. Bronchospasm following ergometrine, Anaesthesia 1979;34:909 doi/pdf/10.1111/j.1365-2044.1979.tb08556.xCrawford JS. Bronchospasm following ergometrine, Anaesthesia 1980;35:397-8 doi: 10.1111/j.1365-2044.1980.tb05138.x.