Korean J Obstet Gynecol.  2009 May;52(5):571-575.

High fever, coronary artery spasm and convulsion associated with prostaglandin E2 in atonic uterine bleeding

• Park JC
• Bae JG
• Kim JI
• Rhee JH

Abstract

Postpartum hemorrhage is a serious condition related with maternal morbidity and mortality. Prior to surgical treatment, oxytocin and prostaglandin analogs administration are common. Pyrexia after prostaglandin E1 was well known, but PG E2 has been shown to have a few complication even though coronary arterial spasm was rarely reported. The 38-year old woman who delivered 3rd baby by Cesarean section was developed the atonic uterine bleeding. During the treatment with high dose sulprostone (PG E2), she complained the anterior chest pain, her body temperature was elevated to 41.2 degrees C, and then convulsion with stuporous mentality was developed. EKG revealed inverted T wave in II. III, aVF lead, and CK-MB, troponin I was elevated. The laboratory test revealed elevated SGOT/SGPT, myoglobin, and metabolic acidosis. But CSF study, blood culture, direct/indirect Coomb's test, brain CT, and echocardiography were all negative. After supportive care, she came to be alert after 10 hours, body temperature was returned to normal after 22 hours, and the laboratory tests were eventually returned to normal within 6 days. She was discharged from the hospital without any complication. We postulate that high dose PG E2 resulted in high fever, coronary artery spasm, and convulsion

Keyword

Postpartum hemorrhage; Sulprostone; Coronary artery spasm; Convulsion

MeSH Terms

Acidosis
Alprostadil
Body Temperature
Brain
Cesarean Section
Chest Pain
Coombs Test
Coronary Vessels
Dinoprostone
Echocardiography
Electrocardiography
Female
Fever
Humans
Myoglobin
Oxytocin
Porphyrins
Postpartum Hemorrhage
Pregnancy
Prostaglandins, Synthetic
Seizures
Spasm
Stupor
Troponin I
Uterine Hemorrhage
Alprostadil
Dinoprostone
Myoglobin
Oxytocin
Porphyrins
Prostaglandins, Synthetic
Troponin I