Uterine Rupture in an Unscarred Uterus Following Induced Labor with Titrated Oral Misoprostol

William Ceurvels¹, Shi-Yann Cheng^2,3*

¹College of Chinese Medicine, China Medical University, Taiwan.
²School of Medicine, China Medical University, Taiwan.
³Department of Obstetrics and Gynecology, China Medical University Beigang Hospital, Taiwan.

DOI: 10.4236/ojog.2015.514112                

Abstract

Misoprostol (Cytotec, Pfizer) is a prostaglandin E1 analogue widely used in labor induction. Understanding of potential risks of misoprostol in labor induction is lacking as the drug is used off-label in most countries. A 35-year-old G3P2 woman with post-date pregnancy at 40 + 3 weeks was induced using titrated oral misoprostol. Following delivery, post-partum hemorrhage was noted and, upon discovery of a uterine wall rupture due to congenital weakness of the myometrium, emergency abdominal total hysterectomy was conducted. Following surgery, the patient made a full recovery and was discharged. The main contraindications for misoprostol in labor induction are a scarred uterus or multipara greater than 4. Uterine wall weakness should be considered as a potential contraindication. Extreme vigilance is required in use of misoprostol for labor induction.

Keywords

Labor Induction, Misoprostol, Post-Partum Hemorrhage, Uterine Rupture

Conflicts of Interest

The authors declare no conflicts of interest.

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