Aim: This study aimed to examine the incidence of uterine rupture and the clinical characteristics of the patients administered misoprostol for second-trimester miscarriage (STM) in our tertiary center.
Materials and Methods: The study was conducted at Etlik Zubeyde Hanim Women’s Health Training and Research Hospital, between January 2011 and December 2021. Patients who received misoprostol with the diagnosis of STM were retrospectively reviewed. Age, obstetric history, uterine scar history, uterine rupture localization, treatment methods, preoperative and postoperative hemoglobin, and erythrocyte replacement amount of patients were recorded from hospital archives. Intravaginal or sublingual 400 mcg misoprostol was given to the patients every three hours in accordance with the International Federation of Gynecology and Obstetrics (FIGO) recommendations of the period according to the years of treatment. Descriptive statistical methods were used in the study.
Results: The number of pregnant women with intrauterine ex-fetus who underwent misoprostol induction in our hospital in the last ten years was 4950, and uterine rupture was detected in 8 of these patients (1.6/1000). The median age of patients was 33±3.7 years. There was one pregnant woman with a history of abortion. Seven of the patients had a history of cesarean section (CS). No patient had a history of surgery except for CS. In four (50%) patients, the rupture occurred in the old incision line. Complete rupture developed in one patient and partial rupture in the remainder. One patient had a total hysterectomy. No surgical complications or maternal death occurred.
Conclusion: In our study, almost all the patients had a history of CS. It was thought that the risk of rupture might have increased in patients with a history of CS. It was also noteworthy that half of the patients had cesarean scar rupture. There is a need for a detailed evaluation of the relationship between misoprostol and rupture with multicenter studies with large patient participation.
Key words: Abortion, miscarriage, misoprostol, second-trimester pregnancy, uterine rupture
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