[l&drocks]

Please help... I have never heard of giving cytotec and pitocin at the same time!!!!!!!!!!!!! IUFD of 13 weeks and md ordered 2 doses of cytotec 50 mcg vaginally four hours apart and then the start Pitocin 20 units in 1000 ml of LR and infuse at 125 ml/hr with next dose of cytotec due in 2 hours after pitocin started. Has anyone ever done and iufd induction this way??? Please help.

[Diehard Bears Fan]

NEVER done at tne at the same time where I work!

[epiphany]

same here.

[LizzyL&DRN]

I don't understand this type of "induction" at 13 weeks. Why don't they just do a D & C and get it over with? We've had a few of these on our unit. I think they are really hard on the patient. Why should she have to be awake and miserable for hours on end to deliver products of conception? And what is really bad is when the nurse treats this like an 18-20+ week demise and photographs the products of conception like it was a fully formed baby.

[l&drocks]

Thank you all so much for your replies... luckily in this case, pt delivered before doc was doing both cytotec and pitocin at same time. As far as a D&C pt did not want to go to surgery for D&C, feared being put to sleep. Thank you all so much.

[?burntout]

Originally Posted by LizzyL&DRN

And what is really bad is when the nurse treats this like an 18-20+ week demise and photographs the products of conception like it was a fully formed baby.

When someone loses a baby, it is their baby no matter how many weeks they are pregnant. I work in RTS and if parents want their babies' remains to bury, we follow the policy we have for this situation and comply with their wishes. We also do what memory items we can for these parents if that is what they want.

[LizzyL&DRN]

I totally agree with you ?burntout about memory items for parents when they experience a loss of a baby. There is nothing more painful! But unless the parents are told what to expect and are absolutely sure they want photos I don't think its right to take photos and place them in the parent's memory box as a suprise when they open the box just because its hospital policy. A 13 week demise is not pretty to look at, it doesn't look like parents would expect a "baby" to look. I always warn parents ahead of time as to what to expect when and if they want to see their baby. If I can get some tasteful photos, I will, but its not possible on a 13 weeker. This kind of seems like a discussion for a different thread.

[babynursewannab]

That's a scary scenario. It sounds like a lovely cocktail for uterine destruction. Has the doc done this before without inducing mad hyper-stim? I'm curious to know.

[fergus51]

Originally Posted by l&drocks

Thank you all so much for your replies... luckily in this case, pt delivered before doc was doing both cytotec and pitocin at same time. As far as a D&C pt did not want to go to surgery for D&C, feared being put to sleep. Thank you all so much.

A patient does not have to be put under a general for a D&C.

[NurseNora]

Originally Posted by babynursewannab

That's a scary scenario. It sounds like a lovely cocktail for uterine destruction. Has the doc done this before without inducing mad hyper-stim? I'm curious to know.

The uterus at 13 weeks is not very sensitive to pitocin. Just doesn't have the receptors yet. The cytotec would have probably worked alone. Another plus with cytotec inductions for midtrimester losses is that the placenta seems to deliver more easily. The cleavage plane hasn't developed yet and retained placenta is common. For some reason, placentas seem to deliver more easily after cytotec administration. Don't know why. Don't know if there's any research on it yet.

I've seen laminaria used in inductions for early demise. They look like small sticks with a string on one end and come in 3 sizes. One or more is placed in the cervical os and swells as it absorbs moisture from the normal secretions. It begins to manually dilate the cervix, making induction with a very unripe cervix easier.