Uterine rupture associated with misoprostol labor induction in women with previous cesarean delivery

Aslan, Halıl; Unlu, Emine; Agar, Mehmet; Ceylan, Yavuz

doi:10.1016/s0301-2115(03)00363-4

Cited by 64 publications

(42 citation statements)

References 13 publications

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“…Characteristics of the 17 included studies (including ours) are shown in Table 1 (case series and cohort studies) and Table 2 (case reports). [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Additional information from one study 14 could not be obtained, despite numerous email and phone attempts. The cases of uterine rupture analysed by incision number and type are shown in Table 3 (case series and cohort studies).…”

Section: Resultsmentioning

confidence: 99%

Misoprostol for second trimester pregnancy termination in women with prior caesarean: a systematic review

Berghella

Airoldi

O'Neill

et al. 2009

BJOG

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Background Second trimester pregnancy induction with misoprostol in women with prior caesarean delivery is not well studied.Objective To estimate the risk of uterine rupture using misoprostol as an induction agent for pregnancy termination in the second trimester of pregnancy in women with prior caesarean delivery.Search strategy Cases of women with a history of prior caesarean delivery and subsequent misoprostol induction for pregnancy termination in the second trimester (16-28 weeks) were obtained from two main data sources. First, a retrospective chart analysis was performed at Thomas Jefferson University Hospital and Christiana Hospital between 1998 and 2004. Second, multiple Medline, Scopus and POPLINE literature searches were performed.Selection criteria Case series and cohort studies of women with one or more prior caesarean delivery (of any type), and with a subsequent pregnancy with induction of labour for pregnancy termination at 16-28 weeks using misoprostol as the initial primary agent were included. Case reports were analysed separately.Data collection and analysis Total cases were analysed by type and number of prior caesarean delivery, for the primary outcome of uterine rupture.Main results The incidence of uterine rupture associated with second trimester misoprostol termination was 0.4% (2/461) in women with one prior low transverse, 0% (0/46) in those with two prior low transverse and 50% (1/2) in those with a prior classical caesarean delivery. One of the cases of uterine rupture in a woman with a prior low transverse caesarean required transfusion. None of the total eight cases (including case reports) of uterine rupture was associated with hysterectomy.Conclusions Second trimester misoprostol termination appears safe among women with one prior low transverse caesarean birth, as it is associated with incidences of uterine rupture of 0.4% (95% confidence interval 0.08-1.67%), of hysterectomy of 0% and of transfusion of 0.2%. There are insufficient data on risk with more than one prior caesarean birth or with prior classical caesarean birth.Keywords Induction, misoprostol, prior cesarean, second trimester.Please cite this paper as: Berghella V, Airoldi J, O'Neill A, Einhorn K, Hoffman M. Misoprostol for second trimester pregnancy termination in women with prior caesarean: a systematic review.

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Section: Resultsmentioning

confidence: 99%

Misoprostol for second trimester pregnancy termination in women with prior caesarean: a systematic review

Berghella

Airoldi

O'Neill

et al. 2009

BJOG

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“…The frequency of uterine rupture in this cohort of subjects ranges between the reported rates for women with previous cesarean delivery and induction of labor in the medical literature. 10, 11 As our study population is from tertiary care centers and may include women with other risk factors for poor outcomes, comparison to other settings must be done with caution. However, it is not anticipated that labor outcomes will be better at a center with fewer available resources for the care of these women.…”

Section: Discussionmentioning

confidence: 99%

Mode of Delivery in Women with Antepartum Fetal Death and Prior Cesarean Delivery

et al. 2010

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We describe obstetric outcomes in a group of patients with prior cesarean delivery (CD) presenting with an intrauterine fetal demise (IUFD). A secondary analysis of an observational study of women with prior CD was performed. All antepartum singleton pregnancies with a prior CD and IUFD ≥ 20 weeks’ gestation or 500 grams were evaluated. Two hundred nine patients met inclusion criteria for analysis. The mean gestational age ± standard deviation at delivery was 31.3 ± 6.5 weeks. The trial of labor rate was 75.6% (158/209), and the vaginal birth after cesarean (VBAC) success rate was 86.7%. Labor induction or augmentation occurred in 83.3% of attempted VBAC. Uterine rupture occurred in five women (2.4%), and in 3.4% of those being induced but none of these required hysterectomy. Women with a history of previous CD and an IUFD often undergo trial of labor with a high VBAC success rate. Uterine rupture complicates 2.4% of such cases.

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“…The rate of uterine rupture with the use of misoprostol on a scarred uterus is unknown; however, a retrospective observational study from one institution in Turkey reported a 9.7% rate of uterine rupture in women with a previous cesarean who were administered 50 mcg of misoprostol vaginally for IOL compared with women without a history of uterine surgery who received 50 mcg of misoprostol vaginally for IOL (4 of 41 vs 0 of 50 women, respectively; P <.001) . Aslan et al reported one dose of vaginal misoprostol was effective for cervical ripening in 74% of women with a previous uterine scar . The remaining women in the study were given 100 mcg of misoprostol orally every 4 hours for up to a total of 6 doses if they had not yet met the cervical ripening criteria or progressed to active labor .…”

Section: Misoprostol: Pge1mentioning

confidence: 99%

The Pharmacology of Prostaglandins for Induction of Labor

Yount,

Lassiter

2013

J Midwife Womens Health

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Prostaglandin medications are frequently used in the process of induction of labor. Understanding the history and research that supports prostaglandin use for induction of labor is crucial for safe practice. Dinoprostone has been the standard of care for cervical ripening in term pregnancies. Misoprostol administration via various routes has been shown to be efficacious. Oral misoprostol in particular is effective and associated with reassuring maternal and fetal outcomes. In addition, cost has become a variable in decision making regarding best practice. More research is necessary to determine the safest medication, route, dose, and interval of administration. This article reviews cervical physiology and endogenous prostaglandin activity in relation to labor, and the pharmacologic profiles of synthetic prostaglandins currently used for induction of labor.

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Uterine rupture associated with misoprostol labor induction in women with previous cesarean delivery

Cited by 64 publications

References 13 publications

Misoprostol for second trimester pregnancy termination in women with prior caesarean: a systematic review

Misoprostol for second trimester pregnancy termination in women with prior caesarean: a systematic review

Mode of Delivery in Women with Antepartum Fetal Death and Prior Cesarean Delivery

The Pharmacology of Prostaglandins for Induction of Labor

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