Uterine Rupture During Second-Trimester Abortion Associated With Misoprostol

Berghahn, Laura; Christensen, Dennis; Droste, Sabine

doi:10.1097/00006250-200111001-00037

Cited by 25 publications

(31 citation statements)

References 7 publications

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“…The uterus was repaired, not necessitating hysterectomy, and no coagulopathy developed. 8 Of the seven cases with three prior low transverse caesarean delivery, none had uterine rupture. Of the two cases with a prior classical caesarean delivery, one, previously described, had a rupture.…”

Section: Resultsmentioning

confidence: 93%

“…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%

“…Two uterine ruptures were reported as single case reports. 7,8 Both occurred in women with two prior caesarean deliveries who presented at 23 weeks. The first woman presented with chorioamnionitis and probable long-standing rupture of membranes.…”

Section: Resultsmentioning

confidence: 99%

“…None of all the eight cases of uterine rupture was associated with maternal mortality. Five 7,8,13,17,18 of the eight cases of uterine rupture occurred during induction of live fetuses.…”

Section: Resultsmentioning

confidence: 99%

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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: 93%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…None of all the eight cases of uterine rupture was associated with maternal mortality. Five 7,8,13,17,18 of the eight cases of uterine rupture occurred during induction of live fetuses.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

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

Berghella

Airoldi

O'Neill

et al. 2009

BJOG

View full text Add to dashboard Cite

show abstract

“…[7][8][9][10][11] Approximately half have been in unscarred uteri, and most have occurred in women with pregnancies of 18-24 weeks gestational age. [12][13][14][15][16] For second trimester abortion (13-24 weeks of gestation), medical abortion with mifepristone followed by a prostaglandin analogue is an appropriate method and has been shown to be safe and effective, according to WHO and the RCOG. [17][18][19][20][21][22] It has been well proven that pretreatment with mifepristone 24-48 hours before prostaglandin administration increases the success rate, shortens the induction-to-abortion interval and reduces the amount of prostaglandins required in the second trimester in unscarred uteri.…”

Section: Discussionmentioning

confidence: 99%