NTOG 2011 02
NTOG 2011 02
NTOG 2011 02
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misoprostol-induced abortion after cesarean<br />
delivery: a systematic review. Obstet Gynecol<br />
2009;113:1117-23.<br />
5. Bagga R, Chaudhary N, Kalra J. Rupture in an<br />
unscarred uterus during second trimester<br />
pregnancy termination with mifepristone and<br />
misoprostol. Int J Gynaecol Obstet 2004;87:42-3.<br />
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Moulopoulos GG, Papapanagiotou AA, Antsaklis<br />
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Hoffman M. Misoprostol for second trimester<br />
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7.<br />
10. Dickinson JE, Brownell P, McGinnis K, Nathan EA.<br />
Mifepristone and second trimester pregnancy<br />
termination for fetal abnormality in Western<br />
Australia: Worth the effort. Aust N Z J Obstet<br />
Gynaecol 2010;50:60-64.<br />
Samenvatting<br />
Een ruptuur in een uterus zonder litteken in het tweede<br />
trimester is zeldzaam. We bespreken een dergelijke<br />
casus en geven een literatuuroverzicht. De ruptuur<br />
ontstond tijdens zwangerschapsafbreking met<br />
misoprostol in het tweede trimester en werd ontdekt<br />
bij curettage. Bekendheid met deze complicatie die<br />
zelden voorkomt in het tweede trimester kan doctor’s<br />
delay en potentieel gevaarlijke curettage voorkomen.<br />
Trefwoorden<br />
uterusruptuur, uterus zonder litteken, complicatie,<br />
tweede trimester, misoprostol<br />
Summary<br />
This case reports the unsuspected rupture of an unscarred<br />
second trimester uterus during self-induced<br />
termination of pregnancy. After five days of misoprostol-induced<br />
abortion at 21-weeks’ gestation, a<br />
woman was referred for intrauterine infection and<br />
failed induction. After undergoing a curettage, a uterine<br />
rupture was suspected. At laparotomy, the foetus<br />
and placenta were found expelled into the right<br />
broad ligament. Rupture of the unscarred second trimester<br />
uterus during misoprostol-induced abortion is<br />
a rare complication. Awareness of the complication<br />
may prevent delay and a potentially unsafe curettage.<br />
11. Brouns JF, Wely M van, Burger MP, Wijngaarden<br />
WJ van. Comparison of two dose regimens of<br />
misoprostol for second-trimester pregnancy<br />
termination. Contraception 2010;82:266-75.<br />
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versus medical methods for second trimester<br />
induced abortion. Cochrane.Database Syst Rev<br />
2008; CD006714.<br />
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SB, Sala ES, Gonzalez LV, et al. Vaginal vs.<br />
sublingual misoprostol with mifepristone for<br />
cervical priming in second-trimester abortion by<br />
dilation and evacuation: a randomized clinical trial.<br />
Contraception 2007;75:230-7.<br />
14. Hackett GA, Reginald P, Paintin DB. Comparison of<br />
the Foley catheter and dinoprostone pessary for<br />
cervical preparation before second trimester<br />
abortion. BJOG 1989;96:1432-4.<br />
15. Jansen NE, Pasker-de Jong PC, Zondervan HA.<br />
Mifepristone and misoprostol versus Dilapan and<br />
sulprostone for second trimester termination of<br />
pregnancy. J Matern Fetal Neonatal Med<br />
2008;21:847-51.<br />
16. Borras A, Gomez O, Sanz M, Martinez JM, Puerto<br />
B. Feticide followed by mifepristone-misoprostol<br />
regimen for midtrimester termination of pregnancy<br />
in two cases of complete placenta previa. Fetal<br />
Diagn Ther 2010;28:114-16.<br />
Keywords<br />
uterine rupture, unscarred uterus, complication,<br />
second trimester, misoprostol<br />
Gemelde (financiële) belangenverstrengeling<br />
geen<br />
Auteurs<br />
Mw. drs. W. Wiltenburg, gynaecoloog, UMC St<br />
Radboud, Nijmegen, thans chef de clinique, Rijnstate<br />
ziekenhuis, Arnhem<br />
Mw. drs. K.M.W.H. Smeets, gynaecoloog, Slingeland<br />
ziekenhuis, Doetinchem<br />
Prof. dr. F.K. Lotgering, gynaecoloog, UMC St Radboud,<br />
Nijmegen<br />
Correspondentieadres<br />
Mw. drs. W. Wiltenburg, gynaecoloog<br />
Afdeling Verloskunde & Gynaecologie<br />
UMC St Radboud<br />
Huispost 791<br />
Postbus 9101<br />
6500 HB Nijmegen<br />
Telefoon: 06 23185569<br />
E-mail: w_wiltenburg@hotmail.com<br />
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