title: Induction of labor in women with a uterine scar.
abstract: OBJECTIVE
  To evaluate the frequency of uterine rupture following induction of labor in women with a previous cesarean section. Misoprostol was compared to other methods of induction.
  
  
  METHODS
  A retrospective cohort study of 208 women attempting induction of labor after one previous cesarean section. Delivery data were collected retrospectively and compared. Group 1(2009-2010) was compared with Group 2 (2012-2013). In Group 1, the main method of induction was vaginal PGE2 (prostaglandin-E2), amniotomy, oxytocin or a balloon catheter. In Group 2, the dominant method of induction was an oral solution of misoprostol.
  
  
  METHODS
  frequency of uterine rupture in the two groups.
  
  
  RESULTS
  Nine cases (4.3%) of uterine rupture occurred. There was no significant difference in the frequency of uterine rupture following the change of method of induction from PGE2, amniotomy, oxytocin or mechanical dilatation with a balloon catheter to orally administered misoprostol (4.1 versus 4.6%, p = 0.9). All ruptures occurred in women with no prior vaginal delivery.
  
  
  CONCLUSIONS
  The shift to oral misoprostol as the primary method of induction in women with a previous cesarean section did not increase the frequency of uterine rupture in the cohort studied.
authors.affiliation: a Department of Clinical Science and Education , Section of Obstetrics and Gynecology, Karolinska Institute, Soder Hospital , Sweden .
authors.forename: David
authors.initials: D
authors.lastname: Stenson
authors.affiliation: a Department of Clinical Science and Education , Section of Obstetrics and Gynecology, Karolinska Institute, Soder Hospital , Sweden .
authors.forename: Tove
authors.initials: T
authors.lastname: Wallstrom
authors.affiliation: a Department of Clinical Science and Education , Section of Obstetrics and Gynecology, Karolinska Institute, Soder Hospital , Sweden .
authors.forename: Maria
authors.initials: M
authors.lastname: Sjostrand
authors.affiliation: b Department of Women's and Children's Health , Uppsala University , Uppsala , Sweden , and.
authors.forename: Helena
authors.initials: H
authors.lastname: Akerud
authors.affiliation: c Department of Women's and Children's Health , Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Gemzell-Danielsson
authors.affiliation: a Department of Clinical Science and Education , Section of Obstetrics and Gynecology, Karolinska Institute, Soder Hospital , Sweden .
authors.forename: Eva
authors.initials: E
authors.lastname: Wiberg-Itzel
mesh_terms: D000284:Administration, Oral; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000009:adverse effects*; D016595:Misoprostol / Q000008:administration & dosage / Q000009:adverse effects*; D010120:Oxytocics / Q000008:administration & dosage / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology*; D011247:Pregnancy; D012189:Retrospective Studies; D014597:Uterine Rupture / Q000209:etiology*
chemical_list: D010120:Oxytocics; D016595:Misoprostol
keywords: Induction of labor; PGE2; TOLAC; misoprostol; uterine scar