Anaphylaxis to oral misoprostol in a term pregnant patient who is non-allergic to vaginal misoprostol-a case report

Abstract

Misoprostol (PGE1) is a drug that is very commonly used in obstetrics for labour induction. Apart from its side effect of causing congenital malformations in offspring of users who have unsuccessfully used it as an abortifacient, it is considered a safe drug with few side effects. We here report a severe hypersensitivity reaction to misoprostol in a 33-year-old term pregnant patient who is non-allergic to vaginal misoprostol. The patient developed anaphylactic features like swelling of lips, low voice due to laryngeal oedema, and bradycardia. Prompt administration of adrenaline and emergent caesarean section allowed for the safe delivery of the neonate. When inducing labour, quick identification and treatment of anaphylaxis and hypersensitivity reactions are necessary to prevent maternal and neonatal morbidity and mortality.