PDF(Pubmed)
Abstract：
Postpartum hemorrhage (PPH) remains the leading cause of maternal mortality, primarily attributed to uterine atony. Both the World Health Organization (WHO) and the International Federation of Gynecology and Obstetrics (FIGO) endorse the use of misoprostol not only for the prevention but also for the treatment of PPH. However, the administration of misoprostol is commonly associated with transient pyrexia, attributed to a shift in the hypothalamic set point observed in certain animal studies. Misoprostol-induced hyperpyrexia can occasionally manifest with a prodrome of shivering, particularly when administered via the sublingual route, which achieves a higher and faster maximum plasma concentration compared to vaginal and rectal routes. General management strategies to reduce fever involve removing clothing and blankets, applying cool compresses, administering oral acetaminophen, and ensuring adequate hydration. While some cases have reported misoprostol-induced convulsions, hyperpyrexia leading to convulsions and subsequent rhabdomyolysis is a rare and potentially lethal side effect. In this case presentation, we emphasize a scenario where misoprostol was employed for the treatment of PPH but led to rhabdomyolysis. Our goal is to highlight the side effects of misoprostol and the significance of considering the initial combination of misoprostol with anti-pyretic management to minimize the risk of hyperthermia-related side effects and prevent additional severe complications.
摘要：
产后出血（PPH）仍然是孕产妇死亡的主要原因，主要归因于子宫收缩。世界卫生组织（WHO）和国际妇产科联合会（FIGO）都认可米索前列醇不仅用于预防而且用于治疗PPH。然而,米索前列醇的给药通常与短暂性发热有关，归因于在某些动物研究中观察到的下丘脑设定点的变化。米索前列醇诱导的高热可偶尔表现为颤抖的前驱症状，特别是当通过舌下途径给药时，与阴道和直肠途径相比，它实现了更高且更快的最大血浆浓度。减少发烧的一般管理策略包括脱衣服和毯子，施加凉爽的压缩，口服对乙酰氨基酚，并确保充分的水化。虽然一些病例报告了米索前列醇引起的惊厥，高热导致惊厥和随后的横纹肌溶解是一种罕见且可能致命的副作用。在这种情况下，我们强调米索前列醇用于治疗PPH,但导致横纹肌溶解的情况.我们的目标是强调米索前列醇的副作用以及考虑将米索前列醇与解热管理初始组合以最大程度地减少与高热相关的副作用的风险并防止其他严重并发症的重要性。
