title: Laparoscopic Management of Uterine Rupture After Early Second-Trimester Medical Abortion in a Patient With a Prior Cesarean Section.
abstract: To show the possibility of laparoscopic management of uterine rupture.
  
  
  
  Video with explanations.
  
  
  
  In the medical management with misoprostol for termination of pregnancy at any time the risk of uterine rupture may be possible. The risk is likely higher in women with a previous uterus surgery. In a systematic review of available studies, the risk of rupture was .28% among women with a prior cesarean delivery who were undergoing second-trimester misoprostol-induced abortion, meaning if 414 women with a history of cesarean delivery were given misoprostol for second-trimester abortion, 1 would experience uterine rupture. Uterine rupture has only been reported 3 times in first-trimester abortion and only once managed via laparoscopy: a missed abortion reported in 2005, a case of a ruptured unscarred uterus in a women undergoing medical abortion, and a case of a delayed miscarriage at 8 weeks' gestation after misoprostol managed by laparotomy and sharp curettage.
  
  
  
  Total laparoscopic management in a patient with uterine tear after misoprostol treatment.
  
  
  
  Early second-trimester medical abortions with misoprostol can cause uterine rupture. In hemodynamically stable cases, total laparoscopic management is possible approach.
authors.affiliation: Department of Obstetrics and Gynecology, Barziali Medical Center, Ben-Gurion University, Ashkelon, Israel. Electronic address: enamazov@gmail.com.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Namazov
authors.affiliation: Department of Obstetrics and Gynecology, Barziali Medical Center, Ben-Gurion University, Ashkelon, Israel.
authors.forename: Leonti
authors.initials: L
authors.lastname: Grin
authors.affiliation: Department of Obstetrics and Gynecology, Barziali Medical Center, Ben-Gurion University, Ashkelon, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Volodarsky
authors.affiliation: Department of Obstetrics and Gynecology, Barziali Medical Center, Ben-Gurion University, Ashkelon, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Anteby
authors.affiliation: Department of Obstetrics and Gynecology, Barziali Medical Center, Ben-Gurion University, Ashkelon, Israel.
authors.forename: Ofer
authors.initials: O
authors.lastname: Gemer
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000009:adverse effects; D000028:Abortion, Induced / Q000009:adverse effects*; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D016595:Misoprostol / Q000009:adverse effects; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D014597:Uterine Rupture / Q000209:etiology / Q000601:surgery*
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol
keywords: Laparoscopy; Misoprostol; Second trimester; Uterine rupture