Re: Rupture uterus at 8 weeks after misoprostol
From: Braun, R. Daniel (rbraun@iupui.edu)
Fri Jun 30 11:53:04 2000
Maybe if NOT repaired.
Dan
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
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-----Original Message-----
From: james connerth [mailto:babydoc@apex.net]
Sent: Friday, June 30, 2000 11:11 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: Rupture uterus at 8 weeks after misoprostol
maybe the scar was defective??Poorly repaired?
"Braun, R. Daniel" wrote:
> Not to my knowledge.
>
> 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
> >
