Re: Rupture uterus at 8 weeks after misoprostol
From: Rupak Ranjan Roy (rupakray@caltiger.com)
Fri Jun 30 20:56:08 2000
No, they did not comment on the 8 weeks bit.
To add one more point. She had two children, one was a vaginal delivery and
the other LSCS, but the report does not say which one was first. If she had
a VBAC before, then this case is probably more unusual.
--
Rupak Ranjan Roy
MRCOG
>----- Original Message -----
From: Braun, R. Daniel <rbraun@iupui.edu>
To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.medispecialty.com>
Sent: 01 July 2000 02:43
Subject: Re: Rupture uterus at 8 weeks after misoprostol
..
>
> Did the people in the article comment on the 8 weeks bit. I have never
heard
> of a uterine rupture at 8 weeks. I have heard of uterine perforations, but
> never a rupture.
>
> RDB
>
> R. Daniel Braun, MD FACOG
> Clinical Professor
> Department of Obstetrics and Gynecology
> Indiana U. School of Medicine
> Indianapolis, IN 46202
>
> OBGYN.net
> International Representative for United States
>
> Certified AllExperts Expert
> Check out my bio/ratings page!
> http://www.allexperts.com/displayExpert.asp?Expert=1236
>
> -----Original Message-----
> From: Rupak Ranjan Roy [mailto:rupakray@caltiger.com]
> Sent: Friday, June 30, 2000 10:28 AM
> To: Multiple recipients of list OB-GYN-L
> Subject: 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
> >
>
