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Uterine rupture and dehiscence associated with intravaginal misoprostol cervical ripening
D A Hill1, R A Chez, J Quinlan
1Department of Obstetrics and Gynecology, Florida Hospital Family Practice Residency, Orlando, USA. dahmd@mpinet.net
Objective:
To evaluate if the prostaglandin E1 analogue misoprostol, when used as an agent for cervical ripening, is associated with uterine rupture.
Study Design:
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.
Conclusion:
Intravaginal misoprostol appears to be associated with an increased incidence of uterine rupture when used in patients undergoing a trial of labor after cesarean.