Misoprostol toxicity

ABSTRACT

Misoprostol is a synthetic prostaglandin E1 analogue, commonly used for the medical termination of pregnancy in the first trimester. We present a case of a 29-year-old woman who was admitted due to misoprostol overdose, for a self induced abortion followed by a second overdose for a suicidal attempt. Manifestations of toxicity included agitation, high-grade fever, abdominal pain, diarrhea and minimal pervaginal bleeding. She was managed by a multidisciplinary team involving Medical, Psychiatric and Gynaecological doctors. Treatment was supportive and included gastric lavage, administration of intravenous fluids, anti-pyretics and analgesics. The pregnancy and fetal viability was followed on serial beta hCG levels and ultrasound scan respectively, and required surgical management of miscarriage. Patient was discharged in satisfactory physical condition