Misoprostol
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Uterine fundus rupture: case report A 27-year-old woman developed uterine fundus rupture following treatment with misoprostol for medical termination. The woman (gravida 3 and para 1), who had pelvic pain was admitted to hospital. A year ago, she had delivered a 1100g female baby by cesarean section because of acute fetal distress. At current presentation, the uterus ultrasonography showed a single fetus consistent with 11 weeks and 5 days with no cardiac activity. In addition, an arcuate uterus was noted. Therefore, she was hospitalised for medical termination. She received a single dose of misoprostol 400µg vaginally. Six hours later, she developed severe abdominal pain. Her blood pressure was 100/60mm Hg and the pulse rate was 96 beats/minute. Her abdomen was distended with guarding and rebound tenderness. She also had chest pain. Transvaginal ultrasonography showed intrauterine gestational sac. A prior cesarean scar was intact and a 9cm deep free fluid collection was noted in the perisplenic and perihepatic spaces. Within two hours, her Hb concentrations decreased. Emergency laparotomy was carried out and uterine fundus rupture 4cm in length was noted, intraoperatively. The ruptured area was occupied by a clot and the gestational sac was still noted in the uterus, which was successfully suctioned. Approximately 1000mL of blood was drained during the operation and the site of rupture was repaired using continuous 1-0absorbable sutures. The woman received a single unit of packed red blood cells and one unit of fresh frozen plasma during laparotomy. An additional unit of red blood cells was given also postoperatively. She was stable after the surgery and was discharged after five days. Can S, et al. What is your diagnosis?. Journal of the Turkish-German Gynecology Association 21: 134-135, No. 2, Jun 2020. Available from: URL: http://doi.org/10.4274/ 803500866 jtgga.galenos.2019.2019.0075
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Reactions 12 Sep 2020 No. 1821
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