Cytotec?

I'm not the OP, but I know what she's talking about. I used to hear bad things about Cytotec on pregnancy boards and stuff all the time.

As a pregnant person, it doesn't look too great when you read the FDA page:

http://www.fda.gov/cder/drug/infopage/misoprostol/default.htm

I guess it's link to uterine rupture??? Uterine hyper-stim (which I realize can be caused by other cervical ripeners too).

I'm just a pregnant NICU nurse who's trying to educate myself on more things L&D. People on other pregnancy boards are visciously anti-Cytotec and I'm kinda trying to get both sides of the story I guess. So please bear with me if I ask lot's of questions.

"curly" -due soon!

ANYtime you mess with nature, you risk complications, and in VERY rare cases, catastrophic outcomes. I have, however, observed cytotec, when used judiciously and in low-risk situations, "relatively" safe. Meaning? Well, it's best to let Mother Nature to do her thing, always. But if you have health problems that make labor ripening or induction beneficial, to the point where such benefits outweigh risks, you may want to consider it. But if it's just for "maternal discomfort" or "social" reasons, you may want to refuse.

Please have this conversation with your doctor or midwife. He/she is the most-qualified to reach a decision in collaboration with you, as to what is the best path to take. There is certainly something to be said for waiting and letting your body do what it is designed to, if you are healthy and there are no problems w/the pregnancy or your baby. Please do not turn this into a medical advice thread-----the internet is not the best place to get such advice.

Thanks for understanding, and good luck. I hope you have a joyous and safe birth experience.

Thanks guys. It was not my intention to seek for medical advice, I was just wondering what you though of the contraversy of Cytotec, if anything.

It's not so controversial as it used to be.....(well the discussion of labor induction versus allowing natural labor to ensue, aside). Its off-label use was called into question, but then, so many drugs are used off-label, really. It's a case of really being sure benefits outweigh risks, in the end, as in any drug or herbal therapy.

Policies are in place in most institutions that really pin down how/when and on whom to use ripening agents like cytotec to reduce dangers/risks of their uses....

SBE said it best, as always.

Cytotec got a really bad rep when, IMO, it was being terribly misused. In most facilities, there are protocols for it's use. And, when used appropriately, it is beneficial as a cervical ripening agent for a medically necessary induction. And, as mentioned earlier, all cervical ripening/induction agents have the same potential adverse reactions.

As far as the controversy goes, I'm sorry that there are still so many scary stories out there for pg women. But, we all know that when people want to share labor/birth stories, they always seem to want to share the horrific ones. I always explain the risks involved with whatever induction agent we are using, and explain to my patients what precautions we take to avoid them.

http://stopcytotec.com/WECAN_STOP_CYTOTEC.php

http://www.tatia.org/

http://inamay.com/view_article.php?Article_ID=18&page_number=1

I'm extremely behind on this but i'm really surprised there isn't more discussion on this. Ask your childbirth educators and they will tell you it is controversial (if not stronger words). I can't wait to read what Henci Goer says about it in her next edition of obstetric myths vs. research realities.

My question is if a baby dies with a cytotec induction HOW on earth can they defend themselves when the searle letter is paraded around in front of a jury? I know most lawsuits are settled out of court but I would think that thought would be enough to stop docs from using it. There are alternatives after all.

It is used off-label and Searle has CYA'd mostly because it costs so little to produce. They can't make enough off of selling Cytotec to pay for all of the research costs involved in clearing it for use in labor-ripening. It doesn't mean there is any cover-up or dangers hidden (don't flame me over the known dangers--we have discussed them and I understand). I have seen it used quite a lot in the past three years and for the most part it works well when used properly.

I am at a teaching facility, and one of the attendings is doing research and trying to develop a Cytotec pesary--like the Cervidil one--to make it easier and safer to use. She has presented at one of my AWHONN chapter's meetings about induction and Cytotec ones in particular and her research shows it to be safe and fairly effective (effective as most any ripening agent!) when used correctly. Interestingly enough--the best labor induction method according to her stats was membrane stripping. Not very comfortable, but it works pretty predictably within a day or two and can be done in the office.

Another thing is the manner in which it came into use. guineapigging

Ok, now, let's remember one thing: "Guinea pigging" is used w/many meds to the benefit of millions of people the world over! If not humans, animals are used, which to me, is just as hard to take, if not more---because they can't refuse!

Yes--- The ethics are debatable---we can go on and on and on, ad nauseum here.

I still say "caveat emptor"-----know your rights, know the risks, know the benefits and decide for yourself what is best for you and your family. I would most strongly advise anyone to actually READ the consents they sign and ask if anything is in anyway unclear or unduly upsetting. And refuse, if the risks do indeed outweigh benefits....it's anyone's right to do so.

This is where being an informed consumer is invaluable. Too few Americans actually bother; I know this for a fact.