What is a potential serious adverse effect of misoprostol when used for abortion?

Misoprostol is a medication commonly used for medical abortion, and while it has various side effects, one of the serious potential adverse effects is uterine rupture. Uterine rupture involves a tear in the uterine wall, which can lead to severe complications, including significant internal bleeding and a risk to the woman's life. This risk is especially pertinent in women with an existing uterine scar, such as those who have undergone a previous cesarean section or uterine surgery, as the integrity of the uterine wall may be compromised.

In the context of abortion, misoprostol can induce strong uterine contractions that can lead to increased pressure on a vulnerable uterus, contributing to the risk of rupture. This is a critical consideration in clinical practice, particularly when assessing a patient's history and any contraindications for the use of misoprostol.

While infection, hemorrhage, and sepsis are also important considerations in the context of medical abortion, they are often related to other complications or procedures rather than being a direct pharmacological effect of misoprostol itself. Uterine rupture stands out as a particularly serious potential adverse outcome directly associated with misoprostol’s action on the uterus.