Anaphylactoid syndrome of pregnancy after intracervical dinoprostone for cervical ripening: a report of 3 cases.
BACKGROUND
Three cases of anaphylactoid syndrome of pregnancy developed in association with the use of intracervical dinoprostone for cervical ripening.


METHODS
All cases occurred at our institution between October 1996 and February 2001. The patients developed respiratory symptoms shortly after placement of 0.25 mg of intracervical dinoprostone gel. Hemodynamic changes, manifested by tetanic uterine contractions and fetal heart rate decelerations, followed. Subsequently all 3 patients developed disseminated intravascular coagulation, characterized by severe hypofibrinogenemia.


CONCLUSIONS
There appears to be an association between intracervical dinoprostone for cervical ripening and anaphylactoid syndrome of pregnancy. Clinicians utilizing this route of dinoprostone administration should be familiar with this rare but potentially life-threatening complication.
Cusick
William
W
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Stamford Hospital, Stamford, Connecticut 06904, USA. wcusick@stamhealth.org
Leuci
Domenico
D
Viscarello
Richard R
RR
Rodis
John F
JF
D000287:Administration, Topical; D000328:Adult; D000707:Anaphylaxis / Q000139:chemically induced*; D020070:Cervical Ripening / Q000187:drug effects*; D015232:Dinoprostone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D004211:Disseminated Intravascular Coagulation / Q000209:etiology*; D005260:Female; D006340:Heart Rate, Fetal; D006801:Humans; D008875:Middle Aged; D010120:Oxytocics / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D011247:Pregnancy; D013577:Syndrome
D010120:Oxytocics; D015232:Dinoprostone