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| No. 10 | 
Jul 15, 2005, 10:34 PM
We still use cytotec to induce labors, pp hem, etc. The MD must be the one to administer this drug, Our orders are usually 25 mcg vag q4 x4 doses. They have given po before, but usually only on the IUFD and usually a higher dosage. We also have used it rectally for pp hems. We do require 4 hours to pass after the last dose before starting Pitocin. I it is very unpredictable, though. You never know who it's going to work on. I had two cytotec inductions this week, both term, both severe pre-ecl. One changed from ft/th/high to 3/50 after 1 dose, where the other one after 4 doses was 1-2 cm (and that was being awfully generous!). You just never know!
 | | Advertisement Sponsored Links | | | | No. 11 |
Jul 16, 2005, 08:43 PM
Originally Posted by SmilingBluEyes It makes a great postpartum hemorrhage treatment----I have seen it stop hemorrhages COLD when used rectally. Like pitocin, it's almost a "different drug" when used postpartum!
My sister just had a PP hemorrhage and she was telling me that they "put a pill up her butt". I had NO idea what she was talking about. Her nurse did say that the Cytotec rectally was the last resort before they had to manually "scrape" her uterus to check for placental fragments. But, the Cytotec did work and the bleeding greatly diminished.
Wow, you learn something new every day!
| | No. 12 |
Jul 16, 2005, 10:20 PM
We use it for induction of IUFD, pp bleeding rectally, and only one doc uses it for induction, but usually after trying cervidil first. We do continuous monitoring on all inductions, cervidil, cytotec and prostin gel. I don't like the unpredictability of it, and the fact that it can't be removed like cervidil.
| | No. 14 |
Jul 17, 2005, 05:01 PM
We only use it for PP hemorrhage and IUFD inductions...
| | No. 15 |
Jul 19, 2005, 06:41 PM
Originally Posted by FrumDoula Cytotec scares the cr*p out of me. It's much less manageable, it seems, than some of the other cervical ripening agents, and therefore less safe. I've heard that women are often not told about its possible side effects, and the fact that it's being used off label.
On another board that I frequent, someone said their homebirth midwife (CNM) wanted to use to help induce labor on a postdates woman. I was absolutely SHOCKED. I thought that with Cytotec, there was specific monitoring protocol, like with Pit or any other chemical intervention, to make sure you're not hyperstiming a woman or causing a rupture. And ruptures have happened frequently enough with Cytotec that I would be wary to use it without some serious monitoring.
Can the L&D RN's here tell me what their monitoring protocol is for Cytotec?
Alison
After placement, Mom is monitored for one hour. Then, Mom is free to roam and we monitor every 2-4 hours "depending on contraction pattern." Whenever she gets more active we swing into a more regular monitoring protocol. Personally, most of us hate using Miso. We much prefer Cervidil.
| | No. 16 |
Jul 19, 2005, 11:11 PM
For the nurses whose L&D units use Cytotec, how extensively are your pregnant clients/patients briefed on the possible side effects of Cytotec, and the FDA warning on it? I know tons of drugs are used off label, but I'm curious if this is also included in the paperwork they sign.
Thanks,
Alison
| | No. 17 |
Jul 20, 2005, 03:59 PM
Originally Posted by HeartsOpenWide Dose your L&D ward still use Cytotec? Do you know if Cytotec was ever banned from being used in L&D? I know it was not approved by the FDA to be used in labor but doctors found "loop holes"
Yes, we are still using it. As a matter of fact, it's the ONLY cervical ripening agent we use. We also have a high c-section rate.
It's evil stuff. I hate it.
| | No. 18 |
Jul 21, 2005, 08:24 PM
Originally Posted by FrumDoula For the nurses whose L&D units use Cytotec, how extensively are your pregnant clients/patients briefed on the possible side effects of Cytotec, and the FDA warning on it? I know tons of drugs are used off label, but I'm curious if this is also included in the paperwork they sign.
Thanks,
Alison
Our consents simply state "delivery and care of baby". However they are briefed on side effects, depends on the doc or nurse. I always explain the possible adverse reactions to Cytotec, Cervidil, and Pitocin. I'm unsure what others nurses do. I feel it is my responsibility to explain Cytotec the same as I would Nubain, or Vistaril, or Brethine......
Unfortunately, some patients don't really care.
| | No. 19 |
Jul 21, 2005, 09:48 PM
 My experience...
I was induced with cytotec with my daughter. I had to sign a waiver that stated it was being used off label and was not approved by the FDA for that use. It also outlined the risks and gave statistics. Interestingly, I was familiar with it because the same one was passed around in my Bradley class so I had read it before and done some research. I would say they definitely attempted to make me aware of the risks, although who knows if most people really read those things. Originally Posted by FrumDoula For the nurses whose L&D units use Cytotec, how extensively are your pregnant clients/patients briefed on the possible side effects of Cytotec, and the FDA warning on it? I know tons of drugs are used off label, but I'm curious if this is also included in the paperwork they sign.
Thanks,
Alison |
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