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Re: Rupture uterus at 8 weeks after misoprostol From: Rupak Ranjan Roy (rupakray@caltiger.com) Fri Jun 30 10:26:54 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Braun, R. Daniel: "Re: Rupture uterus at 8 weeks after misoprostol" Previous message: Myer S. Bornstein, MD, CPE, FACOG: "RE: Experience with QS®5 Perinatal (Corometrics)" Maybe in reply to: Rupak Ranjan Roy: "Rupture uterus at 8 weeks after misoprostol" Next in thread: Braun, R. Daniel: "Re: Rupture uterus at 8 weeks after misoprostol" Misoprostol was given for pre-operative cervical priming. Royal College of Obstetricians and Gynaecologists` guideline recommend a dose of 800 micrograms vaginally 3 -4 hours before surgical evacuation. The authors of the article under discussion conclude that THIS DOSE is unsafe in a woman with a scarred uterus despite reports of its safety published elsewhere (Lawrie A. et al Br. J. Obs.& Gynae. 1996, pg. 1117 - 1119). A lower dose of 400 microgram has also been reported to be optimal for this purpose. By the way, is it used for cervical priming before vacuum aspiration in USA? -- Rupak Ranjan Roy MRCOG >----- Original Message ----- From: Myer S. Bornstein, MD, CPE, FACOG <mborn@massmed.org> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@forum.obgyn.net> Sent: 30 June 2000 23:46 Subject: Re: Rupture uterus at 8 weeks after misoprostol > Why give 800 mgms? > Myer S. Bornstein, MD, CPE, FACOG > > -----Original Message----- > From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Efrain > Ramirez > Sent: Friday, June 30, 2000 08:00 > To: Multiple recipients of list OB-GYN-L > Subject: Re: Rupture uterus at 8 weeks after misoprostol > > That's a first for me - bet for many, many others!!! Why give > misoprostol for an 8 weeks pregnancy? > > At Thu, 29 Jun 2000, Rupak Ranjan Roy wrote: > > > >A case report has been published in the June issue of British Journal of > Obs. and Gynae (called BJOG nowadays) describing the rupture of uterus after > misoprostol in a UK hospital. We do not have the scope to use misoprostol as > it is not available in our country. But this may stimulate some discussion > amongst those who use it regularly. > > > >Briefly, > >A 36 year old woman with one previous caesarean section and one vaginal > delivery requested termination of pregnancy at 8 weeks (gestation confirmed > by ultrasound scan). She was given 800 microgram of misoprostol to prepare > the cervix before surgical evacuation. After 2 and a half hours she had > severe lower abdominal pain and profuse vaginal bleeding. At laparotomy it > was found that the scar had ruptured with division of both the uterine > arteries. A subtotal hysterectomy was carried out. > > > >-- > >Rupak Ranjan Roy > >MRCOG > > > > -- > "Do not take life too seriously. You will never get out of it alive." > > Marianne Williamson > Next message: Braun, R. Daniel: "Re: Rupture uterus at 8 weeks after misoprostol" Previous message: Myer S. Bornstein, MD, CPE, FACOG: "RE: Experience with QS®5 Perinatal (Corometrics)" Maybe in reply to: Rupak Ranjan Roy: "Rupture uterus at 8 weeks after misoprostol" Next in thread: Braun, R. Daniel: "Re: Rupture uterus at 8 weeks after misoprostol"

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