Cytotec inductions

[Miki34]

I've seen more and more requests from doctors to use cytotec only as opposed to also using pitocin. 50mcg/6hr. Have you guys had success with this?

[LibraSunCNM, BSN, MSN, CNM]

I've seen more and more requests from doctors to use cytotec only as opposed to also using pitocin. 50mcg/6hr. Have you guys had success with this?

When you say "as opposed to also using Pitocin," do you mean that you normally give Cytotec and Pit together at the same time? Or are you talking about only using Cytotec for the whole induction? I've never given both at once, that sounds quite risky IMO. I've heard of low-dose Pit being given at the same time as a Foley balloon is inserted, but that's against policy where I work and giving Cytotec and Pit together would be unheard of.

For inductions coming in with Bishop's scores less than 6, we give 50 mcg Cytotec buccally q4h OR 25 mcg lady partslly q4h. When the Bishop's score is 6 or more, we start Pit as needed. Some women take off with one or two Cytotecs, some SROM and progress on their own, etc., but most need some Pit eventually.

[klone, MSN, RN]

Everywhere I've worked has used Cytotec if the cervix is not ripe. We sometimes will use Cervadil.

[12MamaRN24]

Where I work, we use Cytotec 25mcg PO q2h but NEVER with Pit. Sometimes we use it in combination with a Foley bulb. We use Cytotec when a patient's cervix is not "ripe" enough for Pitocin. Once they get to 3-4cm dilated, we switch them over to Pit if their contraction pattern is irregular. Same kind of deal with Cervidil.

[ashleyisawesome, BSN, RN]

We never do cytotec and pit at the same time. Our cervical ripening inductions come in at night (around 2000), get checked/monitored, then get a dose of cytotec around 2200. They are checked again in about 4 hours and given another dose if needed. They stay in a triage room all night. Then they come out to a labor room around 0700 and are started on pitocin if their cervix is favorable/they haven't kicked into labor. If they SROM or progress into active labor during the night, they are brought out to a labor room and either left to labor on their own or started on titrated pit.