Disseminated Intravascular Coagulation Following Induction of Labour with Misoprostol:
Background: Disseminated Intravascular coagulopathy (DIC) has been reported following use of Misoprostol which is an old drug with new indications in Obstetrics and Gynecology. Its effectiveness, low cost, stability in tropical conditions and ease of administration as well as side effects like gastrointestinal effect, uterine rupture and post partum haemorrhage (PPH) have been documented. Method: This is to report a case of disseminated intravascular coagulopathy (DIC) associated with use of misoprostol for induction of labour and to call for extra vigilance in its use. Result: This was a case of 22-year old gravida 2 para 1 at 42 weeks gestation that was induced with 100μg of misoprostol and delivered a live female baby with good Apgar score. She subsequently developed PPH and epistaxis simultaneously, then conjunctival haemorrhage 30 minutes later. She was managed with fresh whole blood and had a satisfactory recovery. Conclusion: Life threatening complication could result from use of Misoprostol. More research and high index of suspicion are needed to establish the association of prostaglandins with DIC.
Keywords: Misoprostol, Induction of Labour, Disseminated intravascular Coagulation
Nigerian Journal of Medicine Vol. 17 (2) 2008: pp. 156-158