Uterine Rupture with Misoprostol at 19 Week of Gestation

Abstract

Objective: Misoprostol is a synthetic prostaglandin E1 analogue that has been used commonly at obstetric practice even though received approval as an oral agent for the preventing of gastric ulcers. Its' widely used at obstetric practice such as first and second trimester pregnancy termination, labor induction at term and management of postpartum hemorrhage. Even though its' efficacy and widespread use, its safety is questioned in women with prior caesarean birth by the reason of increasing number of uterine rupture. Materials and method: We report a second trimester pregnant women with demised fetus with the history of myomectomy and prior low segment caesarean section who had uterine rupture after misoprostol administration. Results: Because of uterine rupture, we performed emergency laparotomy and repaired the rupture line Conclusion: Misoprostol has to be used more careful at patients with prior uterine surgery do to the increased uterine rupture risk.Anahtar Kelimeler: Misoprostol, gebelik, uterus rüptürü Keywords: Misoprostol, pregnancy, uterine rupture Case ReportA 42-year-old pregnant woman was referred to our obstetric department with the diagnosis of intrauterine death at 16 weeks of gestation. This was her second pregnancy. She had the history of a low segment cesarean section concurrently with anterior wall myomectomy. A 16 week and five days (biparietal diameter) demised fetus was observed at sonographic examination. Amniotic fluid was normal and the cervical length was measured 35 mm without any funneling. On her physical examination, blood pressure was 100/70 mmHg and heart rate was 80 beat per minute. Whole blood count, liver function test, urea and creatinine and D-Dimer were counted normal. Bishop score was noted four.