Uterine rupture and dehiscence associated with intravaginal misoprostol cervical ripening.
OBJECTIVE
To evaluate if the prostaglandin E1 analogue misoprostol, when used as an agent for cervical ripening, is associated with uterine rupture.


METHODS
We performed a two-year retrospective chart review to determine the incidence of uterine rupture in patients with a previous cesarean delivery undergoing cervical ripening or the induction of labor.


RESULTS
Uterine dehiscence occurred in 1 and uterine rupture occurred in 3 of 48 women with a prior cesarean delivery treated with 50 micrograms doses of intravaginal misoprostol for cervical ripening. Uterine rupture was found in 1 of 89 women who had an oxytocin infusion for induction of labor and none of the 24 patients who received intravaginal prostaglandin E2 placed for cervical ripening.


CONCLUSIONS
Intravaginal misoprostol appears to be associated with an increased incidence of uterine rupture when used in patients undergoing a trial of labor after cesarean.
Hill
D A
DA
Department of Obstetrics and Gynecology, Florida Hospital Family Practice Residency, Orlando, USA. dahmd@mpinet.net
Chez
R A
RA
Quinlan
J
J
Fuentes
A
A
LaCombe
J
J
D000282:Administration, Intravaginal; D000328:Adult; D000527:Alprostadil / Q000031:analogs & derivatives*; D020070:Cervical Ripening; D005260:Female; D006801:Humans; D008499:Medical Records; D016595:Misoprostol / Q000008:administration & dosage / Q000009:adverse effects*; D011247:Pregnancy; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology; D014219:Trial of Labor; D014597:Uterine Rupture / Q000209:etiology*; D016064:Vaginal Birth after Cesarean
D016595:Misoprostol; D000527:Alprostadil