ARJ
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48) A 22-year-old pregnant woman develops the gradual onset of severe low back pain during her 10th week of pregnancy. She begins taking ibuprofen for control of her symptoms. She has previously had a bleeding ulcer and was prescribed misoprostol, which she began taking to prevent ulcer recurrence. Forty-eight hours later, she has severe vaginal bleeding, and it is determined that she has had a completed abortion. Which of the following is the most likely explanation for this occurrence?
A. Antiphospholipid-induced thrombosis
B. Cyclooxygenase-induced uterine contractions
C. Factor VIII deficiency(induced hemorrhage
D. Lipoxygenase-induced uterine contractions
E. Prostaglandin-induced uterine contractions
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| kabu
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E
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| mani
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E.
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| DrS
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E
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| bajaj123
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E
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| ARJ
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I also think the same
E. Prostaglandin-induced uterine contractions
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| ARJ
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The correct answer is
E. This patient has taken the prostaglandin misoprostol, which is designed to prevent ulcer occurrence with the use of NSAIDs. It is strictly prohibited during pregnancy since it has the predictable effect of inducing uterine smooth muscle contractions. This has actually become part of an "at-home" abortion method using the combination of oral methotrexate and misoprostol. Antiphospholipid antibodies (choice A) may induce thrombosis of placental vessels and cause recurrent second-trimester abortions. However, there is no history to suggest this diagnosis in this patient. Cyclooxygenase and lipoxygenase (choices B and D) are enzymes that are involved in arachidonic acid metabolism. Similarly, there is no evidence given to suggest an underlying factor VIII deficiency (choice C).
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