Uterine rupture during induced mid-trimester abortion.

Uterine rupture during induced mid-trimester abortion is infrequent. Often the diagnosis is established only after manual exploration of the uterus, exploratory laparotomy or even autopsy. It is crucial to establish the diagnosis rapidly and to offer efficient treatment, since the unexpected occurrence of this catastrophe adds to its inherent seriousness. Fourteen cases revealed by a Med-line search and two additional personal cases were reviewed. The most common complaint heralding the rupture was abdominal pain and secondary to it there were signs of blood loss, such as vaginal bleeding, decreased hematocrit level and decreased blood pressure. 72% of women with uterine rupture (10 out of 14) did not abort within 24 h after intra-amniotic injection, and 85% (11 out of 13) had large quantities of oxytocin administered for more than 12 h. The rupture occurred predominantly in the lower segment and there was no preference either for the right or left side of the uterus. It was shown that uterine rupture during mid-trimester induced abortion is not unique to women of high parity or old age. The major complications occurring in induced mid-trimester abortions are similar to those seen in patients who deliver in the third trimester.