Uterine rupture associated with misoprostol labor induction in women with previous cesarean delivery.
OBJECTIVE
To review our experience with uterine rupture in patients undergoing a trial of labor with a history of previous cesarean delivery in which labor was induced with misoprostol.


METHODS
A retrospective chart review was used to select patients who underwent induction of labor with misoprostol during the period from February 1999 to June 2002. Women with a history of cesarean delivery were retrospectively compared with those without uterine scarring.


RESULTS
Uterine rupture occurred in 4 of 41 patients with previous cesarean delivery who had labor induced with misoprostol. The rate of uterine rupture (9.7%) was significantly higher in patients with a previous cesarean delivery (P<0.001). No uterine rupture occurred in 50 patients without uterine scarring. Women with a history of cesarean delivery were more likely to have oxytocin augmentation than those without uterine scarring (41% versus 20%; P=0.037).


CONCLUSIONS
Misoprostol induction of labor increases the risk of uterine rupture in women with a history of cesarean delivery.
Aslan
Halil
H
Department of Perinatology, SSK Bakirkoy Maternity and Children Hospital, Defne 02-03 B-10, Daire 17, 34850 Bahcesehir, Istanbul, Turkey. halil34aslan@hotmail.com
Unlu
Emine
E
Agar
Mehmet
M
Ceylan
Yavuz
Y
D000328:Adult; D005260:Female; D006801:Humans; D007751:Labor, Induced; D008499:Medical Records; D016595:Misoprostol / Q000009:adverse effects*; D010120:Oxytocics / Q000009:adverse effects*; D011247:Pregnancy; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology; D014597:Uterine Rupture / Q000139:chemically induced / Q000453:epidemiology*; D016064:Vaginal Birth after Cesarean
D010120:Oxytocics; D016595:Misoprostol