association between misoprostol induction in pregnant women with uterine rupture in sardjito hospital and afiliation
By:
Kiswa Anggreany
Department of Obstetrics and Gynecology
Faculty of Medicine, Gadjah Mada University/Sardjito Hospital
Yogyakarta
abstract
Background: Misoprostol is a synthetic prostaglandin E1 analogue which is now commonly used for induction of labor. Hyperstimulation is a complication of misoprostol that may lead to uterine rupture.
Objective: To find the association between misoprostol exposure for induction of labor with uterine rupture.
Design: Case control Study
Methods: Case were all women who delivered in Sardjito and affiliate Hospital from January 2007 to November 2012 with the diagnosis of uterine rupture. Control were taken by random from the same hospital. Chi square test and logistic regression were use for statistical analysis.
Result: There were 53 cases of uterine rupture and 199 controls. Risk of of uterine rupture associated with misoprostol exposure was OR
1, 09 (CI 95% 0,52-2,2), while that of oxytocin exposure was 0,80 (CI 95% 0,35-1,85), of vacuum extraction was 2,18 (CI 95% 0,87-5,46), of age > 35 years old was 1,31 (CI 95% 0,61-2,82), of parity > 3 was 2,19 (CI 95% 0,91-5,24), of fetal weight >3500 gr was 3,46 (CI 95% 1,46-8,16). Logistic regretion analysis show that the highest risk factor associated with uterine rupture was fetal weight > 3500 (OR 3,46; CI 1,48-8,56) followed by parity (OR 2,56; CI 1,019-6,465) and vacuum extraction (OR 2,45; 0,94-6,39).
Conclusion: There was no association between misoprostol exposure with uterine rupture. Fetal weight > 3500 gr, Parity > 3, and vacuum extraction increased risk of uterine rupture associated with misoprostol.
Key word: Misoprostol, uterine rupture, parity, fetal weight.