Postpartum eclampsia in a primigravida following misoprostol administration: A case report

Background: Postpartum eclampsia is a rare but potentially life-threatening obstetric emergency that can occur even in women without prior preeclampsia. Misoprostol, a prostaglandin E? analogue, is used widely for the management of postpartum haemorrhage, may, in rare cases, precipitate eclamptic-like seizures when administered in high doses. Case Presentation: A 26-year-old primigravida at 37 + 6 weeks of gestation presented with leaking per vaginum, progressed spontaneously and delivered vaginally. She was administered Tablet Misoprostol 1000 mcg per rectum as a prophylaxis for PPH and subsequently delivered a healthy male neonate weighing 3.485 kg. Two hours postpartum, she developed a generalized tonic-clonic seizure with high-grade fever, vomiting, and disorientation. She was managed as a case of postpartum eclampsia with magnesium sulfate, levetiracetam, intravenous antibiotics, and supportive ICU care. Neuroimaging (CT, MRI/MRA/MRV) and EEG were normal. She stabilized with no further seizures and was discharged in good condition. Conclusion: This case highlights a rare but possible association between Misoprostol (1000 mcg) administration and postpartum eclampsia. Clinicians should monitor patients closely after administration and consider Misoprostol induced postpartum Eclampsia as a differential diagnosis for prompt intervention to prevent life-threatening complications.