Belay Suleiman A, Negussie Michael A, Alemu Yirga W, Andualem Balemlay S, Yitina Eyasu F, Dereje Wondwosen M, Teferi Mikiyas G
School of Medicine, College of Medicine and Health Sciences, University of Gondar, Maraki Street, Gondar City, Central Gondar Zone, PO Box 196, Gondar, Ethiopia.
School of Medicine, College of Health Sciences, Addis Ababa University, Tikur Anbessa Specialized Hospital, Churchill Avenue, Lideta Sub-City, PO Box 5657, Addis Ababa, Ethiopia.
J Surg Case Rep. 2025 Apr 19;2025(4):rjaf233. doi: 10.1093/jscr/rjaf233. eCollection 2025 Apr.
Misoprostol, a prostaglandin E1 analog, is widely used in obstetrics for abortion induction and labor management. Although generally safe, it can lead to rare complications such as uterine rupture, even in patients without prior uterine scarring. This case report describes a 27-year-old gravida 3, para 1 woman with no history of uterine surgery who presented with a second-trimester missed septic abortion. After receiving six sublingual doses of misoprostol (400 μg each) without fetal expulsion, she developed signs of sepsis, including fever, tachycardia, and leukocytosis. Ultrasound revealed an empty uterus with a defect in the anterior wall and the fetus and placenta in the peritoneal cavity. Emergency laparotomy confirmed a complete transverse rupture of the lower uterine segment with necrotic edges. The fetus and placenta were extracted, the uterus was repaired, and the patient recovered well with postoperative antibiotics, being discharged after 7 days. This case highlights uterine rupture as a rare but serious complication of second-trimester abortion with misoprostol, emphasizing the importance of careful monitoring and prompt recognition of complications to ensure patient safety.
米索前列醇是一种前列腺素E1类似物，在产科广泛用于引产和产程管理。尽管通常安全，但它可导致罕见的并发症，如子宫破裂，即使是既往无子宫瘢痕的患者也可能发生。本病例报告描述了一名27岁、孕3产1且无子宫手术史的妇女，她因中期稽留流产合并感染就诊。在舌下含服6剂米索前列醇（每剂400μg）后胎儿仍未排出，随后她出现了败血症的症状，包括发热、心动过速和白细胞增多。超声检查显示子宫空虚，前壁有缺损，胎儿和胎盘位于腹腔内。急诊剖腹探查证实子宫下段完全横断破裂，边缘坏死。取出胎儿和胎盘后，对子宫进行了修复，患者术后使用抗生素恢复良好，7天后出院。本病例突出了子宫破裂是米索前列醇用于中期引产的一种罕见但严重的并发症，强调了仔细监测和及时识别并发症以确保患者安全的重要性。
