Which condition is a contraindication for using Prostaglandin E1?

Prostaglandin E1 (misoprostol) is commonly used in obstetrics for various indications, including induction of labor. However, its use is contraindicated in certain situations, particularly in patients who have had prior uterine surgery, such as a cesarean delivery. This is primarily due to the increased risk of uterine rupture when the uterus has been previously scarred or weakened.

In cases of prior cesarean delivery or major uterine surgery, the integrity of the uterus is compromised, and the use of prostaglandins can increase uterine contractility. This heightened activity can lead to the potential for the scar tissue from the previous surgery to tear, resulting in serious complications for both the mother and the fetus.

In contrast, having a previous low-risk cesarean delivery, high blood pressure, or a single gestation does not inherently pose the same level of risk for uterine rupture and therefore does not serve as a classified contraindication for the use of Prostaglandin E1. Thus, the choice relating to prior cesarean delivery or major uterine surgery is the correct and most clinically relevant concern when considering the use of prostaglandin E1.