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Uterine rupture associated with misoprostol labor induction in women with previous cesarean delivery
Halil Aslan1, Emine Unlu, Mehmet Agar
1Department of Perinatology, SSK Bakirkoy Maternity and Children Hospital, Defne 02-03 B-10, Daire 17, 34850 Bahcesehir, Istanbul, Turkey. halil34aslan@hotmail.com
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.
Study Design:
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).
Conclusion:
Misoprostol induction of labor increases the risk of uterine rupture in women with a history of cesarean delivery.
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