Myocardial infarction after sulprostone therapy for uterine atony and bleeding: A case report

A 30-year woman developed uterine atony and bleeding after induced abortion because of fetal death at 17 weeks' gestation. Sulprostone was administere d intravenously at a Fate of 500 mu g/h. When additional sulprostone was in jected into the uterine cervix the patient sustained a myocardial infarctio n with ventricullar fibrillation and cardiocirculatory arrest, most probabl y due to coronary artery spasm. The patient was resuscitated and recovered completely. To date there are seven published reports of myocardial ischemi a and infarction due to sulprostone therapy. Most of the reported patients were older than 30 years and heavy smokers and received high doses of sulpr ostone, These reports and our patient suggest that sulprostone should be us ed with care, particularly in patients with cardiac risk factors, and only in settings equipped to manage complications.