B B Bennett1. 1. Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, USA.
Abstract
BACKGROUND: Misoprostol (prostaglandin E1) compares favorably with dinoprostone (prostaglandin E2) and oxytocin for labor induction at term. Excessive uterine activity has been reported using high-dose regimens, but no negative effect on outcomes has been observed. CASE: Labor was induced in a 34-year-old multipara at 39 weeks' gestation using intravaginal misoprostol tablets. Five hours after administration of the second 25-microgram dose, fetal bradycardia prompted emergency cesarean delivery. Hysterectomy and left salpingo-oophorectomy were necessary to control bleeding from a 15-cm posterior uterine wall rupture. CONCLUSION: Misoprostol can cause excessive uterine activity and uterine rupture.
BACKGROUND:Misoprostol (prostaglandin E1) compares favorably with dinoprostone (prostaglandin E2) and oxytocin for labor induction at term. Excessive uterine activity has been reported using high-dose regimens, but no negative effect on outcomes has been observed. CASE: Labor was induced in a 34-year-old multipara at 39 weeks' gestation using intravaginal misoprostol tablets. Five hours after administration of the second 25-microgram dose, fetal bradycardia prompted emergency cesarean delivery. Hysterectomy and left salpingo-oophorectomy were necessary to control bleeding from a 15-cm posterior uterine wall rupture. CONCLUSION:Misoprostol can cause excessive uterine activity and uterine rupture.
Authors: Gláucia Virgínia Guerra; José Guilherme Cecatti; João Paulo Souza; Aníbal Faúndes; Sirlei Siani Morais; Ahmet Metin Gülmezoglu; Renato Passini; Mary Angela Parpinelli; Guillermo Carroli Journal: Bull World Health Organ Date: 2011-07-05 Impact factor: 9.408