BACKGROUND: Three cases of anaphylactoid syndrome of pregnancy developed in association with the use of intracervical dinoprostone for cervical ripening. CASES: 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. CONCLUSION: 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.
BACKGROUND: Three cases of anaphylactoid syndrome of pregnancy developed in association with the use of intracervical dinoprostone for cervical ripening. CASES: 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. CONCLUSION: 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.