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Clinical and Experimental Obstetrics & Gynecology  2017, Vol. 44 Issue (3): 477-479    DOI: 10.12891/ceog3422.2017
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Medical management of early pregnancy failure with misoprostol with rupture of the cesarean section scar pregnancy
A.A. Rouzi1, *(), A. Almarzouki1, F. Tallab2, L. Ashkar3
1 Departments of Obstetrics and Gynecology at King Abdulaziz University, Jeddah, Saudi Arabia
2 Departments of Obstetrics and Gynecology at King Abdulaziz Hospital, Jeddah, Saudi Arabia
3 Department of Radiology at King Abdulaziz University, Jeddah, Saudi Arabia
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Abstract  Purpose: To report a case of ruptured uterus in the first trimester with the use of misoprostol for early pregnancy failure in a woman with unrecognized cesarean section scar pregnancy. Case: A 27-year-old woman, gravida 5 para 3+1, presented with abdominal pain and vaginal bleeding. Transvaginal ultrasonography revealed a fetus without fetal heart activity at nine weeks gestation, making the diagnosis of early pregnancy failure. Her previous deliveries were by cesarean section. She was managed medically with misoprostol. Seven hours after misoprostol administration, she developed sudden onset of severe abdominal pain. Repeat transvaginal ultrasonography diagnosed cesarean section scar pregnancy. Laparotomy revealed hemoperitoneum with rupture of cesarean section scar pregnancy. Subtotal hysterectomy was performed. Conclusions: Failure to recognize cesarean section scar pregnancy can result in a ruptured uterus in the first trimester with the use of misoprostol for early pregnancy failure. Increased awareness of the unexpected consequences of cesarean section is of paramount importance.
Key words:  Cesarean section scar pregnancy      Rupture uterus     
Published:  10 June 2017     
*Corresponding Author(s):  A.A. ROUZI     E-mail:  aarouzi@gmail.com

Cite this article: 

A.A. Rouzi, A. Almarzouki, F. Tallab, L. Ashkar. Medical management of early pregnancy failure with misoprostol with rupture of the cesarean section scar pregnancy. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(3): 477-479.

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https://ceog.imrpress.com/EN/10.12891/ceog3422.2017     OR     https://ceog.imrpress.com/EN/Y2017/V44/I3/477

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