Three cases of maternal death following the use of misoprostol are presented. In two of the cases the drug was used to procure illegal abortion, and in the third case maternal death occurred following uterine rupture, after misoprostol was used clinically for induction of labour. A brief review of the usage of misoprostol is presented, including recommendations for its safe use.
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References
1.
BennettB.B. (1997) Uterine rupture during induction of labour at term with intravaginal misoprostol. Obstet. Gynecol. 89, 832–3.
2.
BondG.R.Van-ZeeA. (1994) Overdose of misoprostol in pregnancy. Am. J. Obstet. Gynecol. 171, 561–2.
3.
CostaS.H.VesseyM.P. (1993) Misoprostol and illegal abortions in Rio de Janerio, Brazil. Lancet341, 1258–61.
4.
CreininD.M.VittinghoffE. (1994) Methotrexate and misoprostol vs misoprostol alone for early abortion. A randomized controlled trial. JAMA272, 1190–5.
5.
CreininD.M.VittinghoffE.SchaffE. (1997) Medical abortion with oral methotrexate and vaginal misoprostol. Obstet. Gynecol. 90, 611–16.
6.
DaisleyH. (1989) Ectopic pregnancies in Trinidad. A clinico-pathological study of 154 consecutive surgically treated cases. W. I. Med. J. 38, 222–7.
7.
de JongeM.T.E.MakinD.J.ManefeldtE.De WetH. G.PattinsonC.R. (1995) Randomized clinical trial of medical evacuation and surgical curettage for incomplete miscarriage. BMJ311, 662.
8.
FletcherH.MitchellS.FrederickJ.SimeonD.BrownD. (1994) Intravaginal misoprostol versus dinoprostone as cervical ripening and labor inducing agents. Obstet. Gynecol. 83, 244–7.
9.
GonzalesC.H.VargasF.R.PerezA.B., (1993) Limb deficiency with and without Mobious sequence in seven Brazilian children associated with misoprostol use in the first term. Am. J. Med. Genet. 47, 59–63.
10.
HausknechtU.R. (1995) Methotrexate and misoprostol to terminate early pregnancy. Lancet333, 537–40.
11.
KochM.DezilA.FerrarioF.CapursoL. (1996) Prevention of NSAID-induced GI mucosal injury. Arc. Inter. Med. 156, 2321–2.
12.
LevineA.SchoenbaumC.S.StubblefieldG.P. (1982) Ectopic pregnancy and prior induced abortion. Am. J. Public Health72, 253–6.
13.
LevineS.J. (1995) Misoprostol and non-steroidal anti-inflammatory drugs: A tale of effects, outcomes, and costs. Ann, Inter. Med. 123, 309–10.
14.
MaidenN.MadhokR. (1995) Misoprostol in patients taking non-steroidal anti-inflammatory drugs. Best reserved for elderly patients at high risk. BMJ311, 1518–19.
15.
MundleR.W.YoungC.D. (1996) Vaginal misoprostol for induction of labor: A randomized controlled trial. Obstet. Gynecol. 88, 521–5.
16.
RutterL.T. (1995) Drug combination adds fuel to abortion debate. BMJ311, 705.
17.
Sanchez-RamosL.KaunitzA.M.WearsR.L.DelkeI.GaudierF.L. (1997) Misoprostol for cervical ripening and labor induction. Obstet. Gynecol. 89, 633–42.
18.
SchaffA.E.StadaliusS.L.EisingerH.S.FranksP. (1997) Vaginal misoprostol administered at home after mifepristone (RU486) for abortion. J. Fam. Prac. 44, 353–60.
19.
SearleG.D.Company (1995) Health Care Information Services. Skokie IL 60077.
20.
ShepardT.H. (1995) Mobius syndrome after misoprostol: A possible teratogenic mechanism. Lancet346, 780.
21.
SilversteinF.E.GrahamD.Y.SeniorJ.R., (1995) Misoprostol reduces serious gastrointestinal complications in patients with rheumatoid arthritis receiving non-steroidal anti-inflammatory drugs. A randomized, double-blind, placebo-controlled trial. Ann. Inter. Med. 123, 241–9.
22.
WindrimR.BennettK.MundleW.YoungC.D. (1997) Oral administration of misoprostol for labor induction: A randomized controlled trial. Obstet. Gynecol. 89, 392–7.
23.
ZiemanM.FongK.S.BenowitzL.N.BanskterD.DarneyD.P. (1997) Absorption kinetics of misoprostol with oral or vaginal administration. Obstet. Gynecol. 90, 88–92.
