PMID: 9166339May 1, 1997Paper

Uterine rupture during induction of labor at term with intravaginal misoprostol

Obstetrics and Gynecology
B B Bennett

Abstract

Misoprostol (prostaglandin E1) compares favorably with dinoprostone (prostaglandin E2) and oxytocin for labor induction at term. Excessive uterine activity has been reported using high-dose regimens, but no negative effect on outcomes has been observed. Labor was induced in a 34-year-old multipara at 39 weeks' gestation using intravaginal misoprostol tablets. Five hours after administration of the second 25-microgram dose, fetal bradycardia prompted emergency cesarean delivery. Hysterectomy and left salpingo-oophorectomy were necessary to control bleeding from a 15-cm posterior uterine wall rupture. Misoprostol can cause excessive uterine activity and uterine rupture.

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