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Discussion

Cytotec

I was reading an older thread (like from 2004) questioning how many hospitals were still using cytotec for induction and what their experiences are. I'm curious about how things are now, because in the older post people had differing opinions. We almost exclusively use cytotec for our inductions at my hospital. Pharmacy crushes up a pill into sterile water and sends it up to us. Our protocol is 4 oral doses of 20 every hour, then if ctx are not adequate 2 doses of 40, then if still not adequate then 2 doses of 60. I love this way much, much more than the lady partsl insertion, but it's not something I hear many other hospitals doing. The small doses orally every hour gives you more control of the ctx. We rarely see hyperstim. I find it an effective and safe drug for inductions given the proper circumstances. These patients are on continuous monitoring, IV, etc etc overnight. Then we start pitocin in the morning unless of course labor has already started.

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We only do PO cytotec if the patient has PROMed. Otherwise it's per lady parts, and then only if it's an unripe cervix (if the cervix is ripe, Pit generally is effective). And of course, if it's an IOL for a TOLAC patient, it's contraindicated so it cannot be used at all.

We use cytotec for inductions with unfavorable cervixes(often with first timers too). We cut the 100mcg pill in quarters and insert it lady partslly. Some do give it orally as well. Then we start pit later on(or sometimes we will use a foley bulb as well).

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