Cryptogenic stroke in the setting of intravaginal prostaglandin therapy for elective abortion

Vaginal prostaglandin pessaries are considered safe and effective method of abortion within the first two trimesters of pregnancy. We present a case of a young woman, with no known risk factors for cerebrovascular events, who developed a cryptogenic stroke following administration of intravaginal Misoprostol. Case report and review of the relevant literature. A 30-year-old woman presented with right hemiparesis and aphasia after having received three 600 μg tablets of intravaginal Misoprostol for an elective abortion earlier in the day. A brain MRI revealed an acute ischemic infarction in the left middle cerebral artery territory. An extensive workup for possible etiologies was negative. Intravaginal Misoprostol may be associated with stroke in young women. Further study is required to determine if this case represents an isolated incident, or a true association.