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Obstetrics & Gynecology 2001;98:976-977
© 2001 by The American College of Obstetricians and Gynecologists
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CASE REPORTS

Uterine Rupture During Second-Trimester Abortion Associated With Misoprostol

Laura Berghahn, MD, Dennis Christensen, MD and Sabine Droste, MD

Department of Obstetrics and Gynecology, University of Wisconsin, Madison, Wisconsin

Address reprint requests to: Laura Berghahn, MD, Department of Obstetrics and Gynecology, University of Wisconsin Medical School, H4/636 Clinical Sciences Center, 600 Highland Avenue, Madison, WI 53792; E-mail: ljberghahn{at}hosp.wisc.edu.

BACKGROUND: Misoprostol use is contraindicated in women at term with a history of a uterine scar. There are limited data regarding the use of this drug in the midtrimester.

CASE: A 23-year-old woman with two prior cesareans presented at 23 weeks’ gestation for pregnancy termination by dilation and evacuation. She had laminariae placed the day before and was instructed to take 400 µg of misoprostol intravaginally at midnight, then 400 µg buccally at 6:00 AM the day of the procedure. During the evacuation, uterine rupture was diagnosed. She underwent emergency laparotomy, and the uterus was repaired.

CONCLUSION: Uterine rupture can occur when misoprostol is used in the second trimester in a woman with a uterine scar.




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