امرأة عمرها ٣٢ سنة عندها التهاب مفاصل، تأخذ ديكلوفيناك يومياً، والطبيب يفكر بإضافة ميزوبروستول لحماية المعدة. تقول إنها تحاول الحمل منذ ٦ أشهر ولا تستخدم مانعاً. ما المعلومة الأهم قبل وصفه؟

A 32-year-old woman with arthritis takes daily diclofenac, and the doctor considers adding misoprostol for gastroprotection. She says she has been trying to conceive for 6 months without contraception. What is the most important information before prescribing?

1. Misoprostol increases fertility and helps conception
2. Misoprostol can cause miscarriage and is avoided with possible pregnancy
3. Misoprostol is taken only with milk to reduce diarrhoea
4. Misoprostol is completely safe at every stage of pregnancy

Answer: B) Misoprostol can cause miscarriage and is avoided with possible pregnancy. Misoprostol causes uterine contractions and may lead to miscarriage. It is contraindicated in pregnancy; exclude pregnancy and ensure contraception, or choose a PPI instead.