Hindawi Publishing Corporation Case Reports in Obstetrics and Gynecology Volume 2012, Article ID 931497, 3 pages doi:10.1155/2012/931497 Case Report Complete Cervical Avulsion with Intravaginal Misoprostol for Second Trimester Pregnancy Termination G. R. Sajjan,1 Neelamma Patil,1, 2 Manpreet Kaur,1 Shobha Shirgur,1 Suvarna Nandi,1 and V. Ashwini1 1 Department of Obstetrics & Gynecology, BLDE University Shri B. M. Patil Medical College Hospital and Research Centre, Bijapur 586103, Karnataka, India 2 Bijapur Liberal District Educational University’s Shri B. M. Patil’s Medical College Hospital and Research Center, Bijapur 586103, Karnataka, India Correspondence should be addressed to Neelamma Patil, patilneelgiri@rediﬀmail.com Received 27 March 2012; Accepted 28 June 2012 Academic Editors: P. De Franciscis and S. Salhan Copyright © 2012 G. R. Sajjan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Intravaginal misoprostol, a synthetic PGE1 analogue, has largely replaced all other techniques for pregnancy termination in II trimester, because of its successful results. Incidence of II trimester pregnancy termination has also increased in the present days, because of prenatal diagnosis of pregnancies with serious fetal abnormalities like cardiovascular and skeletal malformations. But there are serious and life threatening complications reported with the use of intravaginal misoprostol. Here we are reporting a case of complete avulsion of cervix from lower part of the uterus, with the use of intravaginal misoprostol, for II trimester termination of pregnancy. So, clinicians dealing with II trimester termination of pregnancy should be aware of such complications. 1. Introduction Misoprostol, a synthetic PGE1 analogue, has replaced all other techniques for pregnancy termination, especially in II trimester, because of its excellent success rate [1]. World over midtrimester abortions constitute only 10%–15% of all induced abortions, but they are responsible for two- thirds of all major complications [2]. Though there are few retrospective studies showing that there is no increased risk of uterine rupture in women undergoing second trimester termination of pregnancy with misoprostol [3], there are many case reports of serious catastrophic complications like uterine rupture and postabortal bleeding necessitating hys- terectomy and blood transfusions with the use of intravaginal misoprostol [4]. These are reported in both scarred uterus as well in unscarred uterus [4]. In this paper, we are describing a case of a completely avulsed cervix from lower uterine segment in an unscarred uterus, in a woman undergoing second trimester pregnancy termination with intravaginal misoprostol. 2. Case Report A healthy 25-years-old, G5P2A2 was referred to our hospital for postabortal bleeding with retained placenta. She gave history of expulsion of fetus 15 minutes prior, following a second trimester termination of pregnancy with intravaginal misoprostol of 3 doses, sixth hourly, as told by the patient, the exact dose was not known. Her obstetric history revealed that she had two fullterm home deliveries, two second trimester terminations of pregnancy: one for missed abortion and another for anomalous fetus. Her last abortion was one and a half years back. On examination, the patient was pale, sweating and air hungered (PR-110 bpm, BP-90/50 mmHg). Per abdomen examination showed that uterus was well contracted and retracted and was about 16 week size. Vulval examination showed bleeding and three tampons were removed from the vagina. The placenta and membranes were removed from the vagina, which were already separated. Then the patient started bleeding profusely. On further examination, the cervix which was completely avulsed