Risk of uterine rupture in labor induction of patients with prior cesarean section: an inner city hospital experience

Am J Obstet Gynecol. 2004 May;190(5):1476-8. doi: 10.1016/j.ajog.2004.02.035.


Objective: This study was undertaken to determine the risk of uterine rupture in patients induced with oxytocin or misoprostol after 1 or more previous cesarean sections.

Study design: Patients with 1 or more previous cesarean sections who delivered after 28 weeks' gestation between 1996 and 2002 were identified by database. Among 3533 total patients, rates of uterine rupture were compared among 4 groups: oxytocin induction (n = 430), misoprostol induction (n = 142), spontaneous labor (n = 2523), and repeat cesarean section without labor (n = 438). Statistical analysis included chi(2) test, Fisher exact test, unpaired t test, and Mantel-Haenszel test.

Results: Rate of rupture was increased in all inductions compared with that of the spontaneous labor group. Among patients with 1 prior cesarean, rupture rates with misoprostol and oxytocin induction were 0.8% and 1.1%, respectively.

Conclusion: Induction of labor with oxytocin or misoprostol is associated with a higher rate of uterine rupture compared with those who deliver after spontaneous labor. After 1 prior cesarean, rupture rate with misoprostol induction is not increased compared with oxytocin induction.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Confidence Intervals
  • Female
  • Gestational Age
  • Hospitals, Urban
  • Humans
  • Incidence
  • Labor, Induced / adverse effects*
  • Labor, Induced / methods
  • Misoprostol / administration & dosage*
  • Odds Ratio
  • Oxytocin / administration & dosage*
  • Pregnancy
  • Pregnancy Outcome*
  • Retrospective Studies
  • Risk Assessment
  • Trial of Labor
  • Uterine Rupture / epidemiology*
  • Uterine Rupture / etiology*
  • Vaginal Birth after Cesarean


  • Misoprostol
  • Oxytocin