Uterine rupture complicating midtrimester abortion. A report of two cases.

Uterine rupture occurring during a midtrimester abortion is rare. This complication may lead to profound shock and death as well as to interference with the patient's future fertility. Two patients sustained a uterine rupture during midtrimester abortion. This complication seems to be preventable. The risk of uterine rupture due to overstimulation is higher when amnioinfusion with prostaglandin or hypertonic saline is combined with the use of other oxytocic drugs. Grand multiparas undergoing amnioinfusion should not be given oxytocin; in the rare cases in which oxytocin is needed, it should be administered cautiously and monitored continuously. When a supplemental agent, such as an oxytocic, is needed, it should not be started until several hours after the amnioinfusion.