title: Profound Hyperthermia After Postpartum Rectal Misoprostol Administration.
abstract: BACKGROUND
  Misoprostol, a synthetic prostaglandin E1 analog, is commonly used for treatment and prevention of postpartum hemorrhage. Known side effects include transient hyperthermia, chills, nausea, vomiting, and diarrhea.
  
  
  METHODS
  After a precipitous vaginal delivery complicated by postpartum hemorrhage (600-mL blood loss), a healthy 21-year-old multiparous patient received 800 micrograms rectal misoprostol. Within 30 minutes, she developed rigors, severe hyperthermia (41.5°C [106.7°F]), tachycardia (170s), and transient encephalopathy. Antibiotics and a cooling protocol were initiated in the intensive care unit. Her abnormal vital signs resolved 7-8 hours later. Extensive workup was negative.
  
  
  CONCLUSIONS
  It is important to consider misoprostol toxicity in postpartum hyperthermia, rigors, and tachycardia. Misoprostol should be used judiciously given a lack of evidence for its effectiveness and its potential for serious side effects.
authors.affiliation: Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kaiser
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Royer
mesh_terms: D000285:Administration, Rectal; D003937:Diagnosis, Differential; D005260:Female; D005334:Fever / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010120:Oxytocics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D055815:Young Adult
chemical_list: D010120:Oxytocics; D016595:Misoprostol