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Correspondence: Dr. Fatema Begum, Assistant Professor, Department of Obstetrics and Gynecology, KhwajaYunus Ali Medical College & Hospital, Enayetpur, Sirajganj, Bangladesh. Phone: 01734852131, E-mail: drfatema.parul@gmail.com Introduction Uterine rupture is an obstetric emergency with a high risk of maternal and fetal mortality and morbidity. It is rare with an incidence ranges from 1 in 8000 to 1 in 15000 pregnancies. It commonly occurs in second and third trimester, especially in woman with scarred uterus. Misoprostol, a synthetic prostaglandin E1 analogue is very effective in terminating early pregnancy failure as it induces uterine contractions and ripens the cervix. Different dose and routes of administration (oral, sublingual, vaginal, rectal) have been used. However the appropriate dose and route of administration are not welldetermined. Here we present a case of first trimester ruptured uterus in a woman with a scarred uterus after induced abortion with mifepristone and misoprostol. Case Report A 25 years old lady gravida 2 para 1+0, was presented at emergency dept. of KhwajaYunus Ali Medical college and Hospital at her 8 weeks of pregnancy with shock after receiving Mifepristone and Misoprostol by herself toinduce abortion. She had one living child delivered by caesarean section 4 months back. For this reason she did not want to continue pregnancy and took Abortificant drug. On general examination, the patient was conscious, paper white, her pulse was 120 beats/min, blood pressure 60/40 mm of Hg, extrimities were cool and clammy. On per abdominal examination revealed generalized tenderness. There was no vaginal discharge or bleeding. A transabdominal scan revealed a bulky empty uterus with huge free intraperitoneal fluid collection. There was sign of scar dehiscence in anterior wall of uterus. Hematological examination showed hemoglobin Abstract Abstract: Uterine rupture is a disastrous obstetric complication, occurring mostly in second and third trimesters. The risk of uterine rupture markedly increases with previous uterine surgeries. Termination of early pregnancy failure by misoprostol is common. However, its use in women with scarred uterus is speculative and usually puts the obstetricians in a stressful condition. Here we present a case of rupture of a scared uterus in the first trimester after using mifepristone and misoprostol. A 25 years old parous lady presented with uterine rupture after taking mifepristone and misoprostol by herself to induce abortion for unwanted pregnancy. Immediate laparotomy was done and the defect was repaired. Termination of pregnancy in a woman with scarred uterus by mifepristone and misoprostol can lead to uterine rupture. It should be used cautiously under close supervision or other routes (vaginal or oral).

First Trimester Rupture of Scarred Uterus After Use of Mifepristone, Misoprostol A-Case Report.