Uterine rupture: a complication of midtrimester abortion

The intraamniotic injection of prostaglandin F2alpha and/or hypertonic saline may be associated with serious uterine and cervical trauma. Multiparity and superimposed uterotonic stimulation by oxytocin are generally thought to be contributory. A patient is described who failed to abort vaginally after an uneventful intraamniotic infusion of prostaglandin F2 alpha in combination with hypertonic saline; 48 hours later she evacuated the uterine contents into the peritoneal cavity through a rent in the uterine fundus. The uterine rupture occurred even though there had been no uterotonic stimulation by oxytocin.