Disruption of Prior Uterine Incision Following Misoprostol for Labor Induction in Women with Previous Cesarean Delivery

Overview

Journal Obstet Gynecol

Specialty Gynecology & Obstetrics

Date 1998 May 8

PMID 9572178

Citations 21

Authors

D A Wing

K Lovett

R H Paul

Affiliations

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Abstract

Background: Although induction of labor in women with prior cesareans is controversial, we compared misoprostol to oxytocin in such women in a randomized trial. The investigation was terminated prematurely because of safety concerns.

Cases: Disruption of the prior uterine incision was found in two of 17 misoprostol-treated women. The first woman underwent repeat cesarean delivery at 42 weeks because of fetal tachycardia and repetitive late decelerations. A 10-cm vertical rent in the anterior myometrium was discovered. The second woman underwent induction for fetal growth restriction. Loss of fetal heart tones and abnormal abdominal contour prompted emergent cesarean for suspected uterine rupture. An 8-cm longitudinal uterine defect was found.

Conclusion: When misoprostol is used in women with previous cesareans, there is a high frequency of disruption of prior uterine incisions.

Citing Articles

Uterine rupture with induction using misoprostol for intrauterine foetal death in the second trimester: A case report.

Yamamoto A, Jn-Charles P Case Rep Womens Health. 2024; 44:e00671.

PMID: 39717109 PMC: 11665375. DOI: 10.1016/j.crwh.2024.e00671.

Short stature and vaginal dinoprostone as independent predictors of composite maternal-newborn adverse outcomes in induction of labor after one previous cesarean: a retrospective cohort study.

Tan S, Bashirudin S, Rajaratnam R, Gan F BMC Pregnancy Childbirth. 2024; 24(1):455.

PMID: 38951754 PMC: 11218360. DOI: 10.1186/s12884-024-06650-5.

LEVEL OF PAIN AND ANALGESICS TAKEN AFTER CESAREAN SECTION AND DIFFERENCES ACCORDING TO TYPE OF ANESTHESIA AND DEMOGRAPHIC FACTORS.

Andric I, Vladic-Spaic D, Karlovic Z, Milas A, Matic B, Simic S Acta Clin Croat. 2023; 61(4):581-587.

PMID: 37868179 PMC: 10588394. DOI: 10.20471/acc.2022.61.04.03.

Artificial rupture of membranes as a mode for induction of labor in women with a previous cesarean section- a retrospective cohort study.

Dick A, Gutman-Ido E, Chill H, Karavani G, Ryvkin I, Porat S BMC Pregnancy Childbirth. 2022; 22(1):886.

PMID: 36447150 PMC: 9710010. DOI: 10.1186/s12884-022-05237-2.

Induction of Labor with Vaginal Dinoprostone (PGE) in Patients with a Previous Cesarean Section: Obstetric and Neonatal Outcomes.

Lopez-Jimenez N, Garcia-Sanchez F, Pailos R, Rodrigo-Alvaro V, Pascual-Pedreno A, Moreno-Cid M J Clin Med. 2021; 10(22).

PMID: 34830502 PMC: 8622073. DOI: 10.3390/jcm10225221.