UTERINE RUPTURE DURING INDUCTION OF LABOR AT TERM WITH INTRAVAGINAL MISOPROSTOL

Background: Misoprostol (prostaglandin E-1) compares favorably with di noprostone (prostaglandin E-1) and oxytocin for labor induction at ter m. Excessive uterine activity has been reported using high-dose regime ns, but no negative effect on outcomes has been observed. Case: Labor was induced in a 34-year-old multipara at 39 weeks' gestation using in travaginal misoprostol tablets. Five hours after administration of the second 25-mu g dose, fetal bradycardia prompted emergency cesarean de livery. Hysterectomy and left salpingo-oophorectomy were necessary to control bleeding from a 15-cm posterior uterine wall rupture. Conclusi on: Misoprostol can cause excessive uterine activity and uterine ruptu re. (C) 1997 by The American College of Obstetricians and Gynecologist s.