Second-Trimester Uterine Rupture Following Medical Termination of Pregnancy Using Misoprostol: A Case from Abha, Saudi Arabia

Abstract

Abstract Spontaneous uterine rupture is an uncommon complication of pregnancy that can result in the extrusion of the amniotic sac and fetal parts through the uterine defect, placental abruption, and major bleeding in the mother. Medical termination using misoprostol and mifepristone has become a common practice in inducing abortion, which may lead to uterine rupture, having serious repercussions for both the mother and the fetus. Here, we report the case of a young grand multiparous woman who suffered uterine rupture consequent to the medical termination of the malformed fetus in the second trimester. This case underlines the importance of detailed obstetric history and a high degree of suspicion toward any atypical presentation or response to drugs. Where clear management guidelines are not available, for example, in cases of grand multiparity, multiple CS or scarred uterus, lower doses of misoprostol, or surgical intervention should be considered for termination of pregnancy. This case served as a deflection point in revising the hospital policy on second-trimester abortion. Another important takeaway message is the lack of awareness about reproductive health and family planning which begs the attention of policymakers in the region.