Congenital Paralytic Ileus in a Premature Baby as a Complication of Hexamethonium Bromide Therapy for Toxaemia of Pregnancy

The increasingly frequent use of the ganglionic blocking agents in the treatment of hypertensive states makes it essential that all toxic effects be reported so that the dangers may be given due consideration. This case of paralytic ileus in a premature baby after the mother had been treated during pregnancy with hexamethonium bromide is therefore reported. To the best of our knowledge only three cases in newborn babies have been recorded (Morris, 1953). The Mother Mrs. G., a primigravida aged 32 years, was admitted to hospital on September 3 during the thirtieth week of pregnancy. She had severe pre-eclampsia. Table 1 is a summary of the clinical findings during the preceding weeks of pregnancy. On October 5 a caesarean section was performed, hexamethonium bromide having been given up to and in-cluding that day. The anaesthetics used were thiopentone, nitrous oxide, oxygen and ether. The indications for caesarean section were (1) progressive deterioration in the patient's condition as evidenced by increasing albumin-uria and oliguria with persistent generalized oedema, in spite of slight lowering in the mean blood pressure read-ings (2) apparent cessation of foetal growth; (3) cervical rigidity contraindicating surgical induction of labour. The baby, a girl, had a birth weight of 3 lb. 4 oz., length of 161 in., head circumference of 11 in. at 34 weeks ' gestation