What is a key contraindication for the use of Methylergometrine (Methergine)?

The correct key contraindication for the use of Methylergometrine (Methergine) is severe hypertension. Methylergometrine is an ergot derivative used to prevent and treat postpartum hemorrhage by inducing uterine contractions. However, it has strong vasoconstrictive properties, which can significantly raise blood pressure. Therefore, the use of this medication in patients with severe hypertension poses a serious risk, potentially exacerbating hypertensive emergencies or leading to complications such as stroke.

While precautions should be taken in patients with previous uterine surgery, who may be at higher risk for uterine rupture or have concerns regarding uterine tone, the most critical contraindication remains the risk of increasing blood pressure in hypertensive patients. Although hypersensitivity to ergot derivatives is also a contraindication, the most immediate and severe risk with Methylergometrine arises from its effects on blood pressure, which makes severe hypertension a key contraindication. The interaction with HIV anti-retroviral therapy doesn't directly affect the use of Methylergometrine in the same urgent manner, as there are no known significant contraindications or interactions between the two.