Uterine rupture and dehiscence associated with intravaginal misoprostol cervical ripening

J Reprod Med. 2000 Oct;45(10):823-6.


Objective: To evaluate if the prostaglandin E1 analogue misoprostol, when used as an agent for cervical ripening, is associated with uterine rupture.

Study design: We performed a two-year retrospective chart review to determine the incidence of uterine rupture in patients with a previous cesarean delivery undergoing cervical ripening or the induction of labor.

Results: Uterine dehiscence occurred in 1 and uterine rupture occurred in 3 of 48 women with a prior cesarean delivery treated with 50 micrograms doses of intravaginal misoprostol for cervical ripening. Uterine rupture was found in 1 of 89 women who had an oxytocin infusion for induction of labor and none of the 24 patients who received intravaginal prostaglandin E2 placed for cervical ripening.

Conclusion: Intravaginal misoprostol appears to be associated with an increased incidence of uterine rupture when used in patients undergoing a trial of labor after cesarean.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intravaginal
  • Adult
  • Alprostadil / analogs & derivatives*
  • Cervical Ripening*
  • Female
  • Humans
  • Medical Records
  • Misoprostol / administration & dosage
  • Misoprostol / adverse effects*
  • Pregnancy
  • Retrospective Studies
  • Surgical Wound Dehiscence / etiology
  • Trial of Labor*
  • Uterine Rupture / etiology*
  • Vaginal Birth after Cesarean*


  • Misoprostol
  • Alprostadil