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Avoid Misoprostol in VBAC Patients.
Caution may be the best medicine when considering misoprostol use in patients undergoing a trial of labor after a prior caesarian delivery, according to Dr. Sanchez Ramos.
He and his associate reviewed 18 cohort studies looking at the incidence of uterine rupture in patients undergoing vaginal birth after cesarean section (VBAC) who were induced with various agents (Clin. Obstet. Gynecol. 43[3]:513-23, 2000).
Patients were induced with misoprostol, oxytocin, or prostaglandin [E.sub.2] ([PGE.sub.2]). The investigators found a much higher rate of uterine rupture rupture after misprostol induction (5.4%) compared with [PGE.sub.2] induction (1.6%), oxytocin induction (1.1%), or spontaneous delivery (0.72%).
"Until more data are available regarding the safety and efficacy of misoprostoll induction in VBAC patients, its use in this setting should be restricted to research protocol," he said at the meeting.
Another recent study lends support to a cautious approach to misoprostol use and VBAC.
Misoprostol was associated with a 6% increased incidence of uterine rupture in women undergoing VBAC who were given 50 [micro]g of misoprostol, ...
- Small Dose of Misoprostol Is Safe in Some VBAC Patients.(Brief Article)
- Magazine article from: Family Practice News JOHNSON, KATE July 15, 2001 700+ words
...misoprostol in VBAC patients stems from...hyperstimulation, and uterine rupture. "This...groups of VBAC patients: 100 received...cases of uterine rupture in any of...documented one uterine rupture in a pilot study of 12 VBAC patients who ...
- Improved Selection of VBAC Patients Advised.
- Magazine article from: OB GYN News DEMOTT, KATHRYN December 1, 2000 700+ words
...identify those women at high risk for uterine rupture, Dr. Judith U. Hibbard said at...nearly a ninefold increase in true uterine rupture. Still, Dr. Hibbard found it...the failed VBAC group. The rate of uterine rupture in the study was well within the expected...
- Misoprostol Linked to Uterine Rupture in VBAC.
- Magazine article from: OB GYN News BAKER, BARBARA March 1, 2000 700+ words
...associated risk of uterine rupture is too high," Dr...s safe in non-VBAC patients as a cervical ripening...associates found uterine rupture occurred in 5 of...five instances of uterine rupture occurred in a total...
- Counsel Patients on Risk of Uterine Rupture.
- Magazine article from: OB GYN News DONOHUE, MAUREEN September 1, 2000 700+ words
...management in a hospital setting where a uterine rupture can be recognized and managed expediently...risk factors increase the chances of uterine rupture. Dr. Caughey of the department of...hysterotomy carries about a 12% rate of uterine rupture in subsequent pregnancies. However...
- High uterine rupture risk with high maximum oxytocin dose
- Magazine article from: Inpharma Weekly Anonymous August 23, 2008 700+ words
...appears to be a 'unacceptable' risk of uterine rupture associated with higher maximum oxytocin...effect of maximum oxytocin dose on uterine rupture in such patients, researchers analysed...oxytocin were assessed; 62 patients with uterine rupture were compared to 210 patients ...
- Uterine rupture and dehiscence: Ten-year review and case-control study.
- Magazine article from: Southern Medical Journal Diaz, Sumac D. Jones, Jacob E. Seryakov, Michael Mann, William J. April 1, 2002 700+ words
...fetal macrosomia increase the risk of uterine rupture or dehiscence (URD). Methods...and endometritis (10%). Uterine rupture/dehiscence was independently associated...fetal status. ********** UTERINE RUPTURE is an uncommon obstetric complication...
- Study data from Laval University update understanding of uterine rupture.
- Magazine article from: Women's Health Weekly March 19, 2009 700+ words
...of thinning and, thus, to predict uterine rupture. However, the best measuring technique...scientists in Canada report (see also Uterine Rupture). "Sonographic evaluation of the...the patient experienced a large uterine rupture during a trial of labor at term...
- Researchers from Ohio State University report on findings in uterine rupture.
- Magazine article from: Women's Health Weekly November 20, 2008 700+ words
...cesarean delivery' new findings in uterine rupture. "By 2004, only 9.2% of women...cesarean delivery (VBAC)-TOL is uterine rupture, which can lead to perinatal death...the United States report (see also Uterine Rupture). "Risk factors for uterine rupture...