Uterine ruptures as a result of misoprostol in primigravida woman

our purpose is to report the experience of uterine rupture in a primigravida patient with uterine anomaly for whom misoprostol is used for induced abortion in the second trimester. Misoprostol is a synthetic analogue of E1 prostaglandin which is used to prevent the ulcer peptic causing NSAID. Misoprostol is prescribed for oral, sublingual, vaginal and rectal consumptions to force induced labor and termination in mid-pregnancy and it is also used for dilation and suction in the first trimester. Food and Drug Administration presents the side effects of Misoprostol usage as follow: Uterine hyper stimulation, uterine tetany, uterine ruptures, shocks maternal death, fetus bradycardia and death as well as Meconium amnion fluid.
Uterine rupture in women with uterine anomalies is one of the rare yet serious complications in the second trimester of induced labor and the anomaly rate is between 0.5 to 1.8. Pregnancy in rudimentary horn is rare but it is followed with lethal side effects such as uterine rupture, abortion, ectopic pregnancy and etc. The review of this study indicates that not enough data is available in order to support the usage of Misoprostol for women with uterine anomaly.
although uterine rupture is rarely followed by the usage of Misoprostol, it is of great importance to take in to consideration the irrecoverable complications which compel us undertaking vital cautions and also make sure of the normality of uterine before prescribing Misoprostol.