Are they still using Cytotec?

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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"

The hospital where I work most certainly uses Cytotec, at 25 or 50mcg lady partslly for labor induction at term, 200mcg lady partslly for 2nd or 3rd trimester fetal demise, and 800mcg rectally for postpartum hemorrhage. Women requiring preterm induction before the 36th or 37th week are sent to another facility with a Level III NICU.

We don't use it as often as we use Prostin, 2.5mg of this in KY jelly, compounded by us in the pharmacy and kept frozen until use. They sometimes use the suppositories for fetal demise but the 200mcg Cytotec is much more common, mainly because it's MUCH less expensive.

Cervidil is not used at our facility because it has to be placed by the physician and Cytotec or Prostin can be placed by the nurse. My SIL had two Cervidil inductions in another city and had no problems related to this either time.

Terbutaline is ordered for PRN use. Not being a nurse, let alone working in L&D, I'm not sure how often it's used but we really don't send a lot up there.

Edit: Whenever we hire a new technician, they will often ask why the Cytotec bottle has a drawing of a pregnant woman with a no parking sign on it, and we're sending this to L&D. We explain why.

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The hospital where I work most certainly uses Cytotec, at 25 or 50mcg lady partslly for labor induction at term, 200mcg lady partslly for 2nd or 3rd trimester fetal demise, and 800mcg rectally for postpartum hemorrhage. Women requiring preterm induction before the 36th or 37th week are sent to another facility with a Level III NICU.

We don't use it as often as we use Prostin, 2.5mg of this in KY jelly, compounded by us in the pharmacy and kept frozen until use. They sometimes use the suppositories for fetal demise but the 200mcg Cytotec is much more common, mainly because it's MUCH less expensive.

Cervidil is not used at our facility because it has to be placed by the physician and Cytotec or Prostin can be placed by the nurse. My SIL had two Cervidil inductions in another city and had no problems related to this either time.

Terbutaline is ordered for PRN use. Not being a nurse, let alone working in L&D, I'm not sure how often it's used but we really don't send a lot up there.

Edit: Whenever we hire a new technician, they will often ask why the Cytotec bottle has a drawing of a pregnant woman with a no parking sign on it, and we're sending this to L&D. We explain why.

and what is the response?

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and what is the response?

It must work, or we wouldn't use it. I'm a pharmacist, not a nurse, but I come here because it's the only huge message board for medical professionals I can find.

I have no children, but the only induction method I have really heard anyone complain about is Pitocin. One woman said, "A man must have invented that.":lol_hitti

Sorry to hear about your sister.

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LOL , Thanks:lol2: Your Joke was funny! I am nursing student with strong veiws on cytotec. pherhaps because a cytotec "mishap" greatly affected the life of someone i love very much. I am not very objective in this matter.

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Specializes in OBSTERTICS-POSTPARTUM,L/D AND HIGH-RISK.

We use it half the time and cervidil the other half. Reguardless of which drug they get, they are on the monitor the entire time. They normally can eat after an hour. These patients are also started on our high risk antepartum unit and then transfered to L/D for their pitocin induction.

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Specializes in Critical Care.

This past May I had an induction and the meds that we discussed before hand were the cervidil (on the rope?) and pitocin. I am considered high-risk due to age and diabetes so I was seeing a perinatologist for my prenatal care. the plan was come in on Sunday night for the cervidil and start pit the next morning. She wasn't on call when I went in to start but I knew that before hand. Their call is from 5PM to 5PM. She figured that she would come on at 5 and we would have the baby soon after.

My son, apparently had other ideas and was comfy right were he was. After inserting the cervidil on Sunday night I spent a comfortable night with the occassional twinge. The next morning the on call doctor wasn't happy with my progress so she came in and told me they were going to use another med that was a pill inserted lady partslly. No other explanation. After that we would wait for 4 hours before starting the pit. They did tell me that I could get up and shower because after the pill was put in I would be in bed until I delivered.

Now, I am at fault for not asking, but nothing was volunteered by ANYONE. Knowing now what I didn't know then, I would certainly ask for time to walk and all before even considering it.

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Specializes in OB, lactation.

We use cytotec all the time & never cervidil - I was told because of the cost.

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They did tell me that I could get up and shower because after the pill was put in I would be in bed until I delivered.

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I am curious about that. I was induced with cytotec and after being monitored for an hour I was up, walking, in the tub, etc. Interesting the different practices.

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At my hospital in La., we use 25mcg vag q 4 hrs. x 3 doses. We cycle BP q 10 mins x 3, q 30 mins x 3 then q hr. until the next dose. After the 3rd dose, we wait 4 hrs, then start pit. I think we can do up to 6 doses if needed.

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

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Specializes in Gynecology.

I work on a gyne floor (not L&D or OBS) so I cannot speak for what is used on the other floors in our facility, however, we do always use cytotec for induction of our bereavement pts who are terminating e.g. IUFD, lethal abnormalities, etc. It is ordered to be given q4h and is preferred to be given lady partslly, but it can only be given PV by a physician. If the physician cannot come for whatever reason, we may give it PR or PO. We have no specific monitoring protocol for cytotec, but when we are caring for a bereavement, it is 1:1 nursing.

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Specializes in Nurse Leader specializing in Labor & Delivery.

Oh, wow. Any reason for bumping a five-year-old thread?

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It's been approved via the "loop hole" you suggest and yes we ARE still using it. All the time.

It's much the same as using Brethine to stop PTL or Magnesium Sulfate to lower blood pressure. Off-market use of drugs is something that is done all the time. Not to say complacency is appropriate because obviously it's not. But yes, Cytotec is used by many practioners for cervical ripening.

Please don't take this the wrong way but isn't the use of Magnesium sulfate in PIH to reduce the risk of seizures by relaxing the muscles and not to lower b/p?

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