Author(s)

William Ceurvels¹, Shi-Yann Cheng^2,3*

¹College of Chinese Medicine, China Medical University, Taichung.
²School of Medicine, China Medical University, Taichung.
³Department of Obstetrics and Gynecology, China Medical University Beigang Hospital, Chiayi.

Misoprostol (Cytotec, Pfizer) is a prostaglandin E1 analogue widely used in labor induction. Understanding of potential risks of misoprostol in labor induction is lacking as the drug is used off-label in most countries. A 35-year-old G3P2 woman with post-date pregnancy at 40 + 3 weeks was induced using titrated oral misoprostol. Following delivery, post-partum hemorrhage was noted and, upon discovery of a uterine wall rupture due to congenital weakness of the myometrium, emergency abdominal total hysterectomy was conducted. Following surgery, the patient made a full recovery and was discharged. The main contraindications for misoprostol in labor induction are a scarred uterus or multipara greater than 4. Uterine wall weakness should be considered as a potential contraindication. Extreme vigilance is required in use of misoprostol for labor induction.

Labor Induction, Misoprostol, Post-Partum Hemorrhage, Uterine Rupture

Ceurvels, W. and Cheng, S. (2015) Uterine Rupture in an Unscarred Uterus Following Induced Labor with Titrated Oral Misoprostol. Open Journal of Obstetrics and Gynecology, 5, 795-798. doi: 10.4236/ojog.2015.514112.