Uterine rupture during induced mid-trimester abortion

Area of Science:

• Obstetrics and Gynecology
• Reproductive Health
• Surgical Complications

Background:

• Uterine rupture during induced mid-trimester abortion is an infrequent but severe complication.
• Diagnosis is often delayed, occurring after invasive procedures or autopsy.
• Rapid diagnosis and effective treatment are critical due to the catastrophic nature of the event.

Purpose of the Study:

• To review cases of uterine rupture during induced mid-trimester abortion.
• To identify common presenting symptoms and associated factors.
• To highlight the importance of timely diagnosis and management.

Main Methods:

• A Medline search was conducted to identify relevant cases.
• Two additional personal cases were included in the review.
• Clinical data from a total of 16 cases were analyzed.

Main Results:

• Abdominal pain was the most common presenting complaint, followed by signs of blood loss (vaginal bleeding, decreased hematocrit, hypotension).
• A high percentage of women (72%) did not abort within 24 hours post-intra-amniotic injection.
• Prolonged oxytocin administration (>12 hours) was common (85%). Ruptures occurred in the lower uterine segment without lateral preference.
• Uterine rupture is not limited to high-parity or older women.

Conclusions:

• Uterine rupture during induced mid-trimester abortion requires prompt recognition and management.
• Delayed abortion and extensive oxytocin use are associated factors.
• Complication profiles resemble those of third-trimester delivery complications.