Document Detail

Uterine rupture after prostaglandin analogues to induce midtrimester abortion.
MedLine Citation:
PMID:  22439053     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Although prostaglandins are largely used and considered safe drugs to induce midtrimester abortion, the literature reports several cases of uterine rupture consequent to their administration. We report the second ever-described case of uterine rupture after administration of gemeprost and sulprostone for midtrimester abortion in a 45 years-old women with scarred uterus.She was admitted to our Unit for termination at 20 weeks' gestation because of trisomy 21 diagnosed by chromosomal analysis of amniotic liquid at 16 weeks' gestation. Five pessaries of gemeprost (one pessary, every 3 hours) were administered into the posterior vaginal fornix. Since the cervix remained closed and uneffaced, another cycle of 5 gemeprost administration was conducted. When the cervix changed in consistency and dilatation, we decided to administrate sulprostone. At the obstetric examination any visible fetus was evidenced. The abdominal ultrasonography showed an empty uterine cavity and the gestational sac with the dead fetus in abdomen. Emergency laparotomy was therefore undertaken. Primary suture of the ruptured uterus was initially attempted but in vain. Therefore, total abdominal hysterectomy was performed to control bleeding and eventual hypovolemic shock.Given the lack of strong evidence in literature and the fact that case reports are not an optimal method for assessing frequency of an event nor the overall risks of a procedure since they frequently report rare single events, other larger studies are needed to assess whether women with multiple risk factors (e.g. advanced age and previous uterine surgery), and administered with prostaglandins' association have a higher risk of uterine rupture.
Elisa Maria Pappalardo; Michele La Greca; Giusi Rapisarda; Daniele Consoli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of prenatal medicine     Volume:  4     ISSN:  1971-3282     ISO Abbreviation:  J Prenat Med     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2012-03-22     Completed Date:  2012-08-23     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101522906     Medline TA:  J Prenat Med     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  9-11     Citation Subset:  -    
Department of Gynecology and Obstetrics, Garibaldi Nesima Hospital, Catania, Italy.
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