Hsieh Y Y, Tsai H D, Chang C C, Yeh L S, Yang T C, Hsu T Y
Department of Obstetrics and Gynecology, China Medical College Hospital, Taichung, Taiwan, ROC.
Zhonghua Yi Xue Za Zhi (Taipei). 2000 Jan;63(1):58-61.
Misoprostol has been widely applied in early pregnancy termination and term pregnancy induction. However, the upper dosage limit of misoprostol through vaginal route has not been firmly established. Most popular dosages of vaginal misoprostol recommended are 25, 50 or 100 micrograms. There are no reports on the dangers of high-dosage misoprostol 200 micrograms as used in term labor induction. We present a primiparaous woman who was administered 200 micrograms misoprostol vaginally for term labor induction. The following precipitate delivery resulted in multiple lacerations of the isthmus, cervix and vagina, postpartum hemorrhage and disseminated intravascular coagulopathy. Inevitably, a hysterectomy was performed. A postsurgical check of the uterus confirmed lacerations of the isthmus and internal cervix. This rare complication suggests the possible dangers of vaginal misoprostol doses as high as 200 micrograms for term induction of labor at term.
米索前列醇已广泛应用于早期妊娠终止和足月妊娠引产。然而，经阴道途径使用米索前列醇的剂量上限尚未确定。推荐的经阴道使用米索前列醇的最常用剂量为25、50或100微克。目前尚无关于足月引产中使用200微克高剂量米索前列醇危险性的报道。我们报告一名初产妇，经阴道给予200微克米索前列醇进行足月引产。随后的急产导致子宫峡部、宫颈和阴道多处裂伤、产后出血及弥散性血管内凝血。不可避免地，进行了子宫切除术。术后对子宫的检查证实子宫峡部和宫颈内口有裂伤。这种罕见的并发症提示，足月引产时经阴道使用高达200微克剂量的米索前列醇可能存在危险。
