Uterine rupture associated with misoprostol labor induction in women with previous cesarean delivery

Eur J Obstet Gynecol Reprod Biol. 2004 Mar 15;113(1):45-8. doi: 10.1016/S0301-2115(03)00363-4.


Objective: To review our experience with uterine rupture in patients undergoing a trial of labor with a history of previous cesarean delivery in which labor was induced with misoprostol.

Study design: A retrospective chart review was used to select patients who underwent induction of labor with misoprostol during the period from February 1999 to June 2002. Women with a history of cesarean delivery were retrospectively compared with those without uterine scarring.

Results: Uterine rupture occurred in 4 of 41 patients with previous cesarean delivery who had labor induced with misoprostol. The rate of uterine rupture (9.7%) was significantly higher in patients with a previous cesarean delivery (P<0.001). No uterine rupture occurred in 50 patients without uterine scarring. Women with a history of cesarean delivery were more likely to have oxytocin augmentation than those without uterine scarring (41% versus 20%; P=0.037).

Conclusion: Misoprostol induction of labor increases the risk of uterine rupture in women with a history of cesarean delivery.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Humans
  • Labor, Induced*
  • Medical Records
  • Misoprostol / adverse effects*
  • Oxytocics / adverse effects*
  • Pregnancy
  • Retrospective Studies
  • Turkey / epidemiology
  • Uterine Rupture / chemically induced
  • Uterine Rupture / epidemiology*
  • Vaginal Birth after Cesarean*


  • Oxytocics
  • Misoprostol