Uterine Rupture Following Misoprostol Induction of Labour at
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Induction of labour is a common obstetric intervention and world-wide, 20-30% of deliveries are induced [1]. Options for pharmacological induction are prostaglandin E1, E2, F2 analogues and oxytocin drips. Misoprostol a prostaglandin E1, has been a long-standing agent for induction with lack of sufficient statistical evidence to measure its rare and serious side effects such as uterine rupture, bleeding, failure and uterine hyper-stimulation.

Case report of a 33-year-old G5P3+1SA diagnosed with an intrauterine foetal death at 36 weeks gestation and induction of labour started with 400 ug of misoprostol vaginally, which was complicated by a uterine rupture with subsequent referral and management in our facility. Intra-operative findings during laparotomy revealed uterine rupture with a macerated still birth intra-abdominally and moderate hemoperitoneum.

Uterine rupture in an unscarred uterus following unsuccessful induction is an adverse effect that needs to be monitored and also requiring high index of suspicion to be diagnosed. A missed diagnosis of a uterine rupture during induction of labour could result in maternal mortality due to shock from severe hemoperitoneum.

Incidence of uterine rupture following misoprostol induction is rarely recorded due to its use in gynecological practice which has been off label, hence there is need to document this occurrence experienced in the facility.

Dr. R●j S●●●a
Dr. R●j S●●●a Obstetrics and Gynaecology
400 mcg is a very high dose. Induction shold have been done only with 25 or 50 mcg dose
Apr 2, 2020Like
Dr. V●●●●●●j D●●●i
Dr. V●●●●●●j D●●●i Legal Medicine
Every sensible obstetrician prefers safer drugs for induction of labour. What is the hurry for ? Safer drugs are slower but reliable.
Apr 3, 2020Like