Lessons Learnt from Cases of Misoprostol-Based Pregnancy Termination Followed by Uterine Rupture: Report of ۳ Cases

With increase in the second-trimester pregnancy termination, debates continue on the most suitable mode of termination. Misoprostol is used as an agent for the medical abortion. Some authors believe that uterine rupture risk as a complication of medical termination is higher in the patients with positive cesarean section history while some others have no report of such effect. This complication cannot be predicted and can occur under various circumstances with different misoprostol regimens. Hereby, we reported three cases with positive cesarean section history undergoing second-trimester pregnancy termination due to preterm premature rupture of the membranes (PPROM) who developed uterine rupture with similar misoprostol dosages. Finally, we conclude that more cautions should be undertaken in the setting of PPROM with previous history of cesarean section or gestational age >۲۰ weeks about uterine rupture risk and full recommended misoprostol dose must not be administered to prevent life-threatening events.

Keywords:

Uterine rupture , Second trimester pregnancy termination , Misoprostol , Vaginal birth after cesarean (VBAC)