Uterine Rupture in Second Trimester Due to Misoprostol Use: A Case Report and Literature Review

Intravaginal misoprostol is used worldwide with excellent results for second-trimester pregnancy termination. However, it has a rare but serious complication of uterine rupture, both in previously scarred and unscarred uteri. In this report, we present a case of this rare complication in an unscarred uterus during termination with misoprostol. Uterine rupture was found on laparotomy after the patient showed signs of shock during termination. A 2- to 3-cm laceration was detected in the uterine wall along with the left cornea. The placenta was attached to the uterus on the other side. We found an unusual pregnancy in the cornea and successfully repaired it. Although using misoprostol for termination is safe, a regimen protocol should be established. However, uterine structure and implantation safety should be confirmed before administrating misoprostol. This case highlights a difficult diagnosis of abnormal placentation, especially cornual ectopic pregnancy.