Uterine rupture during induction of labor at term with intravaginal misoprostol.
BACKGROUND
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.


METHODS
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.


CONCLUSIONS
Misoprostol can cause excessive uterine activity and uterine rupture.
Bennett
B B
BB
Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, USA.
D000282:Administration, Intravaginal; D000328:Adult; D002585:Cesarean Section; D004630:Emergencies; D005260:Female; D005316:Fetal Distress / Q000139:chemically induced; D006801:Humans; D007044:Hysterectomy; D007751:Labor, Induced / Q000009:adverse effects*; D016595:Misoprostol / Q000009:adverse effects*; D010052:Ovariectomy; D010120:Oxytocics / Q000009:adverse effects*; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D014597:Uterine Rupture / Q000139:chemically induced* / Q000601:surgery
D010120:Oxytocics; D016595:Misoprostol