Critical limb ischemia after accidental subcutaneous infusion of sulprostone.
A 34-year-old patient was treated with constant intravenous infusion of sulprostone because of postpartum hemorrhage from a hypotonic uterus. The arm in which sulprostone had been infused was painful 23 h after infusion. A day later, the arm was found to be blueish, edematous and extremely painful as a result of arterial spasm. The vasospasm was probably caused by accidental subcutaneous infusion of sulprostone as a result of a displaced intravenous catheter. A diagnosis of critical limb ischemia was made. Treatment with the prostacyclin-analogue iloprost resulted in full recovery. Critical limb ischemia as a serious complication of sulprostone has not been previously reported.
de Koning
Y W
YW
Department of Obstetrics and Gynaecology, Erasmus University, School of Medicine and Health Sciences, DR Rotterdam, The Netherlands.
Plaisier
P W
PW
Tan
I L
IL
Lotgering
F K
FK
D000328:Adult; D001132:Arm / Q000098:blood supply*; D016640:Diabetes, Gestational; D015232:Dinoprostone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D006801:Humans; D016285:Iloprost / Q000627:therapeutic use; D007511:Ischemia / Q000139:chemically induced* / Q000188:drug therapy; D007752:Obstetric Labor, Premature; D006473:Postpartum Hemorrhage / Q000188:drug therapy; D011247:Pregnancy; D014665:Vasodilator Agents / Q000627:therapeutic use
D014665:Vasodilator Agents; C016767:sulprostone; D016285:Iloprost; D015232:Dinoprostone