another cytotec question...

  1. For demises, one dr here gives 400mcg cytotec po every 4 hours.
    My question is how long can you do this before its harmful, or does it matter? Is there a limit? I haven't found policy that addresses it, but will dig for that later.
    Thanks!
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  2. 17 Comments

  3. by   Caseyrnbsn
    We have one physician who is new to our facility and she uses 50mcg every 3 hours orally for IUFD's. I also am looking for information to write a procedure for it's use. Let me know if find and good information or already written procedures.
  4. by   SmilingBluEyes
    Have you tried the perinatal archives? They have LOTS of info regarding the use of cytotec in all situations.
  5. by   OBNurseShelley
    How do you get to the perinatal archives, is this the same as the perinatal listserve i've heard of?
  6. by   SmilingBluEyes
    yes it is.
  7. by   elleRN
    we use 200 - 400 mcg intra vaginally every 4 - 6 hours. really effective for IUFD's. also for post partum hemmorage rectally works great...
  8. by   mark_LD_RN
    my main concern with cytotec is hyperstimulation and possible rupture. have not seen it cause one yet but it does concern me. and it does work great for pp hemorhage.

    their is a doc at a near by hospital that is using cytotec to induce vbacs at 37 weeks. to me that seems a little risky
  9. by   ShandyLynnRN
    eww... the policies I have seen definitely say that history of any uterine surgery is a CONTRAINDICATION for use.
  10. by   mark_LD_RN
    that's the way i feel about it also
  11. by   SmilingBluEyes
    WE NEVER EVER use it for VBAC's period. EEEK Mark, that makes me way uneasy. I am uneasy about using cytotec for live deliveries anyhow. THAT really freaks me out. Read the perintal archives/listserve. There are plenty of scary threads/experiences regarding cytotec.
  12. by   HazeK
    Protocol for Demise patients:

    100mcg vaginally q3 hrs x 3....then
    200mcg vaginally q3 hrs x 3....then
    300mcg vaginally q3 hrs x 3....then
    400 mcg vaginally q3 hrs x 3....
    then MD must re-evaluate pt for need for additional laminaria placement or mechanical dilatation!

    (PERSONALLY, HAVE NEVER, EVER SEEN MORE THAN 300MCG NEEDED.)

    Protocol for live births, for cervical ripening:

    25 mcg placed vaginally per MD q4 hrs, up to total of 4 times....then
    50 mcg placed vaginally per MD....

    (PERSONALLY, HAVE NEVER SEEN MORE THAN 2 DOSES GIVEN)

    **** NEVER, EVER USE CYTOTEC ON UTERUS W/ PREVIOUS INCISION ****
  13. by   moz
    Thanks for all the input, I intended to reply earlier but having problems with my internet access.
    I guess also what I am wondering is how much is too much before it causes harm to the mother, or will it? Isn't too much of anything a bad thing? Like ASA/bleeding; acetaminophen/liver damage, etc. Any ideas out there?
  14. by   moz
    oh, and to HazeK-
    at the hospital I previously worked we never gave cytotec on uterus with previous incision, but just last week here a dr gave 100mcg po q 4 hrs on a 26wk demise, who had 2 c/s previously. She delivered vaginally, but had to have a d&c for the placenta.

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