Cardiac Arrest Associated with Sulprostone Use during Caesarean Section
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Published:
Sep 26, 2019
Keywords:
cardiac arrest, Caesarean section, sulprostone
Main Article Content
Abstract
Sulprostone, a synthetic prostaglandin E2 with potent
uterotonic action. We present a case in which intravenous
infusion of sulprostone 500 micrograms within 30 minutes
was administered to treat postpartum hemorrhage during
caesarean section. The 44-years-old patient with no
previous cardiac disease or smoking history developed
ventricular fibrillation and subsequent asystole.
Cardiopulmonary resuscitation was successful after 9
minutes. Post resuscitation there was no myocardial
infarction and she remained unconscious, she had
Glasgow coma scale 7 at the time of discharge. We
postulate that sulprostone resulted in coronary spasm that
resulted in cardiac arrest.
Article Details
Section
Case reports
References
Melis GB, Fruzzetti F, Paoletti AM, et al. Use of a new
synthetic prostaglandin (sulprostone) in various obstetrical
conditions. Minerva Ginecol 1982;34(3):183-90.
2. Feenstra J, Borst F, Huige MC, et al. Acute myocardial infarct
following sulprostone administration. Ned Tijdschr Geneeskd
1998;142(4):192-5.
3. Larsson B, Jonasson A, Carlstrom K. Sulprostone, a synthetic
PGE2 analogue in first trimester abortion. Clinical efficacy
and influence on serum progesterone of different single
doses. Gynaecol Obstet Invest 1990;29:10-12.
4. World Health Organization. Menstrual regulation by
intramuscular injections of 16-phenoxy-tetranor PGE2
methyl-sulfonylamide (sulprostone). A multi centre study.
Br J Obstet Gynaecol 1989;96:207-12.
5. Henshaw RC, Cooper K, el-Refaey H, et al. Medical
management of miscarriage: non surgical uterine evacuation
of incomplete and inevitable spontaneous abortion. Br Med
J 1993;306:894-5.
6. Laudanski T, Litorowicz A, Akerlund M. Induction of labor in
intrauterine fetal death with 16-phenoxy-prostaglandin-E2-
methysulfonylamide (sulprostone)-effects on uterine
contractility, coagulation and kallikrein-kinin systems.
Gynecol Obstet Invest 1990;29:269-72.
7. Poeschmann RP, Doesburg WH, Eskes TK. A randomized
comparison of oxytocin, sulprostone and placebo in the
management of the third stage of labour. Br J Obstet
Gynaecol 1991;98:528-30.
8. Van Selm M, Kanhai HH, Keirse MJ. Preventing the
recurrence of atonic postpartum haemorrhage: a double
blind trial. Acta Obstet Gynaecol Scand 1995;74:270-4.
9. Goffinet F, Haddad B, Carbonne B, et al. Practical use of
sulprostone in the treatment of hemorrhages during delivery.
J Gynecol Obstet Biol Reprod Paris 1995;24:209-16.
10. Aronson JK. Meyler’s Side Effects of Drugs: The International
Encyclopedia of Adverse Drugs Reactions and Interactions.
Volume 6. 16thedition. Amsterdam: Elsevier; 2016. p 597.
11. Fliers E, Duren DR, Van Zweiten A. A prostaglandin analogue
as a possible cause of myocardial infarction in a young
woman. Br Med J 1991;302:416-7.
12. Anonymous. A death associated with mifepristone/
sulprostone. Lancet 1991;337:969-970.
13. Bagni E, Bompani B, Magnavacchi P, et al. Angina
prolungata dopo somministrazione di un derivato sintico di
PGE2. G-Ital-Cardiol 1993;23:719-21.
14. Beerendonk CC, Massuger LF, Lucassen AM, et al. Circulatory
arrest following sulprostone administration in postpartum
hemorrhage. Ned Tijdschr Geneeskd 1998;142(4):195-7.
15. Delay M, Genestal M, Carrie D, et al. Cardiocirculatory arrest
after administration of combined mifepristone (Mifegyne) and
sulprostone (Nalador) for induced abortion. Possible role of
coronary vasospasm. Arch Mal Coeur Vaiss 1992;85(1):105-7.
Chen FG, Koh KF, Chong YS. Cardiac arrest associated with
sulprostone use during caesarean section. Anaesth Intensive
Care 1998;26(3):298-301.
17. Krumnikl JJ, Buttiger BW, Strittmatter HJ, et al. Complete
recovery after 2 h of cardiopulmonary resuscitation following
high-dose prostaglandin treatment for atonic uterine
haemorrhage. Acta Anaesthesiol Scand 2002;46(9):1168-70.
18. Velez RS, Preumont N, Mols P, et al. Ventricular fibrillation
secondary to ergotamine in a healthy young woman. Acta
Cardiol 1999;54(5):283-6.
19. Roithinger FX, Punzengruber C, Gremmel F, et al. Myocardial
infarction after chronic ergotamine abuse. Eur Heart J
1993;14(11):1579-81.
20. Yasue H, Omote S, Takizawa A, et al. Acute myocardial
infarction induced by ergotamine tartrate: possible role of
coronary arterial spasm. Angiology 1981;32(6):414-8.
21. Utensute U. Ventricular fibrillation in patient who received
ergotamine. Journal of Charoenkrung Pracharak Hospital
2016;12(1):52-61.
22. Okutucu S, Karakulak UN, Kabakcu G, et al. An unusual
cause of chest pain: Acute coronary syndrome following
administration of ergotamine tartrate. Exp Clin Cardiol
2012;17(1):43-44.
23. Xue JK, Leng QY, Gao YZ, et al. Factors influencing outcomes
after cardiopulmonary resuscitation in emergency
department. World J Emerg Med 2013;4(3):183-189.
24. Greer DM. Mechanisms of injury in hypoxic-ischemic
encephalopathy: implications to therapy. Semin Neurol
2006;26(4):373-9.
25. Elmer J, Callaway CW. The Brain after Cardiac Arrest.
Semin Neurol 2017;37(1):19-24.
26. Hickey RW, Kochanek PM, Ferimer H, et al. Induced
hyperthermia exacerbates neurologic neuronal histologic
damage after asphyxial cardiac arrest in rats. Crit Care Med
2003;31(2):531-35.
27. Beamish RE, Das PK, Karmazyn M, et al. Prostaglandins and
heart disease. Can J Cardiol 1985;1:66-74.
28. Evers AS, Murphree S, Saffitz JE, et al. Effects of
endogenously produced leukotrienes, thromboxane and
prostaglandins on coronary vascular resistance in rabbit
myocardial infarction. J Clin Invest 1985;75:992-9.
29. Neri S, Gensini GF, Abbate R, et al. Physiologic role of
coronary PG12 and PGE2 in modulating vascular response
to sympathetic stimulation. Am Heart J 1990;119:848-54.
30. Needleman P, Kulkarni PS, Raz A. Coronary tone modulation:
formation and actions of prostaglandins, endoperoxides, and
thromboxanes. Science 1977;195(4276):409-12.
synthetic prostaglandin (sulprostone) in various obstetrical
conditions. Minerva Ginecol 1982;34(3):183-90.
2. Feenstra J, Borst F, Huige MC, et al. Acute myocardial infarct
following sulprostone administration. Ned Tijdschr Geneeskd
1998;142(4):192-5.
3. Larsson B, Jonasson A, Carlstrom K. Sulprostone, a synthetic
PGE2 analogue in first trimester abortion. Clinical efficacy
and influence on serum progesterone of different single
doses. Gynaecol Obstet Invest 1990;29:10-12.
4. World Health Organization. Menstrual regulation by
intramuscular injections of 16-phenoxy-tetranor PGE2
methyl-sulfonylamide (sulprostone). A multi centre study.
Br J Obstet Gynaecol 1989;96:207-12.
5. Henshaw RC, Cooper K, el-Refaey H, et al. Medical
management of miscarriage: non surgical uterine evacuation
of incomplete and inevitable spontaneous abortion. Br Med
J 1993;306:894-5.
6. Laudanski T, Litorowicz A, Akerlund M. Induction of labor in
intrauterine fetal death with 16-phenoxy-prostaglandin-E2-
methysulfonylamide (sulprostone)-effects on uterine
contractility, coagulation and kallikrein-kinin systems.
Gynecol Obstet Invest 1990;29:269-72.
7. Poeschmann RP, Doesburg WH, Eskes TK. A randomized
comparison of oxytocin, sulprostone and placebo in the
management of the third stage of labour. Br J Obstet
Gynaecol 1991;98:528-30.
8. Van Selm M, Kanhai HH, Keirse MJ. Preventing the
recurrence of atonic postpartum haemorrhage: a double
blind trial. Acta Obstet Gynaecol Scand 1995;74:270-4.
9. Goffinet F, Haddad B, Carbonne B, et al. Practical use of
sulprostone in the treatment of hemorrhages during delivery.
J Gynecol Obstet Biol Reprod Paris 1995;24:209-16.
10. Aronson JK. Meyler’s Side Effects of Drugs: The International
Encyclopedia of Adverse Drugs Reactions and Interactions.
Volume 6. 16thedition. Amsterdam: Elsevier; 2016. p 597.
11. Fliers E, Duren DR, Van Zweiten A. A prostaglandin analogue
as a possible cause of myocardial infarction in a young
woman. Br Med J 1991;302:416-7.
12. Anonymous. A death associated with mifepristone/
sulprostone. Lancet 1991;337:969-970.
13. Bagni E, Bompani B, Magnavacchi P, et al. Angina
prolungata dopo somministrazione di un derivato sintico di
PGE2. G-Ital-Cardiol 1993;23:719-21.
14. Beerendonk CC, Massuger LF, Lucassen AM, et al. Circulatory
arrest following sulprostone administration in postpartum
hemorrhage. Ned Tijdschr Geneeskd 1998;142(4):195-7.
15. Delay M, Genestal M, Carrie D, et al. Cardiocirculatory arrest
after administration of combined mifepristone (Mifegyne) and
sulprostone (Nalador) for induced abortion. Possible role of
coronary vasospasm. Arch Mal Coeur Vaiss 1992;85(1):105-7.
Chen FG, Koh KF, Chong YS. Cardiac arrest associated with
sulprostone use during caesarean section. Anaesth Intensive
Care 1998;26(3):298-301.
17. Krumnikl JJ, Buttiger BW, Strittmatter HJ, et al. Complete
recovery after 2 h of cardiopulmonary resuscitation following
high-dose prostaglandin treatment for atonic uterine
haemorrhage. Acta Anaesthesiol Scand 2002;46(9):1168-70.
18. Velez RS, Preumont N, Mols P, et al. Ventricular fibrillation
secondary to ergotamine in a healthy young woman. Acta
Cardiol 1999;54(5):283-6.
19. Roithinger FX, Punzengruber C, Gremmel F, et al. Myocardial
infarction after chronic ergotamine abuse. Eur Heart J
1993;14(11):1579-81.
20. Yasue H, Omote S, Takizawa A, et al. Acute myocardial
infarction induced by ergotamine tartrate: possible role of
coronary arterial spasm. Angiology 1981;32(6):414-8.
21. Utensute U. Ventricular fibrillation in patient who received
ergotamine. Journal of Charoenkrung Pracharak Hospital
2016;12(1):52-61.
22. Okutucu S, Karakulak UN, Kabakcu G, et al. An unusual
cause of chest pain: Acute coronary syndrome following
administration of ergotamine tartrate. Exp Clin Cardiol
2012;17(1):43-44.
23. Xue JK, Leng QY, Gao YZ, et al. Factors influencing outcomes
after cardiopulmonary resuscitation in emergency
department. World J Emerg Med 2013;4(3):183-189.
24. Greer DM. Mechanisms of injury in hypoxic-ischemic
encephalopathy: implications to therapy. Semin Neurol
2006;26(4):373-9.
25. Elmer J, Callaway CW. The Brain after Cardiac Arrest.
Semin Neurol 2017;37(1):19-24.
26. Hickey RW, Kochanek PM, Ferimer H, et al. Induced
hyperthermia exacerbates neurologic neuronal histologic
damage after asphyxial cardiac arrest in rats. Crit Care Med
2003;31(2):531-35.
27. Beamish RE, Das PK, Karmazyn M, et al. Prostaglandins and
heart disease. Can J Cardiol 1985;1:66-74.
28. Evers AS, Murphree S, Saffitz JE, et al. Effects of
endogenously produced leukotrienes, thromboxane and
prostaglandins on coronary vascular resistance in rabbit
myocardial infarction. J Clin Invest 1985;75:992-9.
29. Neri S, Gensini GF, Abbate R, et al. Physiologic role of
coronary PG12 and PGE2 in modulating vascular response
to sympathetic stimulation. Am Heart J 1990;119:848-54.
30. Needleman P, Kulkarni PS, Raz A. Coronary tone modulation:
formation and actions of prostaglandins, endoperoxides, and
thromboxanes. Science 1977;195(4276):409-12.