Cytotec for induction policy

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Hi to everyone and what a great website. I am a fairly new L&D nurse (9months) and love it. I work in a small rural hospital where we do about 20-30 deliveries a month. Our OB/GYN uses a lot of cytotec for cervical ripening. 100mcg po. We currently do not have a policy that I have been able to find and have been searching the internet for help. THat is how I found allnurses.com. If anyone can help me out with a policy on it I would greatly appreciate it. We do currently have a consent on cytotec . Thanks for any info you can give me.

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Specializes in student; help!.

I can't answer, but I'm curious: do you get truly informed consent, or do the docs just get "consent"? I was given terb with DD1 and the doc basically told me what she needed to say to get me to consent. I was freaked out enough by her being freaked out that I didn't think to ask a lot of questions, but when I found out it was off-label and she didn't tell me, I was livid. I'm always curious about consent now...

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Specializes in ICU/ER.

I am in ICU nurse who always wanted to be an OB nurse. So on occasion I am able to pick up hours as the baby nurse in OB, anyways----we stopped using cytotec, we had one OB who used it, and his births came hard and fast and we ended up having one mom with some complications. So now, no more. I know the OB staff is glad. They dreaded that order.

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Yes we do actually get a consent signed and it does state that it is not FDA approved but that it has been studied extensively and is found to be safe and effective for cervical ripening. It also gives percentage of cases of systemic side effects that occur, fetal distress as seen by abnormalities in the baby's heartbeat due to prolonged contractions or those which are close together and last but not less than 1% may require further treatment including possible C/S. Now with all that said, our population of pregnant women here is very young, uneducated and an increased population of mexican nationals that speak no english. Not many of them understand really what we are talking about even if we explain in laymens terms. So I don't know, would you consider that a true informed consent. When they sign the consent they are certifying that they have read and understand and believe that they have been given sufficient info to give this informed consent and authorize use of cytotec.

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Fortunately for us we have not had a bad experience yet, but from some of the info I have found on the internet bad things happen. Maybe we haven't seen this because we are such a small hospital.

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Specializes in OB, House Sup, ER, Med Surg.

We use Cytotec. We do 25-50 mcg vag against posterior fornix of cervix. The CNM or MD inserts it. We rarely use Pit, and have a low C/S rate.

Dr or CNM always goes through risks and mentions the off-label use. I have had a few (very few) moms change their minds when they hear the risks and decide to wait for labor.

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