Another Cytotec question

  1. I reread the other Cytotec posting, but couldn't find what I'm looking for. Two nights ago, I had a fetal demise at 15 weeks (by US) and by dates she was now 18 weeks. She had had 2 doses of Cytotec at home (200mcgs each time) and was now at the hospital with orders for more.

    My question is this: how much are you guys giving for early IUFD's? I checked her cervix and it was closed and long. I asked all the nurses I was working with and they didn't know if the ordered amount was ok either. I just want to hear what you guys are giving in similar situations? Thanks.
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    Joined: Dec '01; Posts: 79
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  3. by   anitame
    It depends on the provider. The last one I did was ordered 200mcg X 1 then 100mcg q 12 hours. Took around 36 hours for the delivery. We don't use it PO at all and the Cytotec is NOT used at home here.
  4. by   L&D.RN
    Was that for an IUFD? or is it the same for induction of either where you work? I specifically want to know the doseages for IUFD inductions. The order I was given called for 800 mcg q 4 hours, and that was following the patient taking 2 doseages of cytotec, 200mcgs each time, 4 hours apart at home and then coming in to the hospital.
  5. by   anitame
    That was for the last IUFD induction I did. For our term viable pregnancy inductions we use 25-50mcg per dose. It seems like one of our other providers does 200mcg per dose for IUFDs. That poor patient of yours must have been painful. 800mcg. WOW.
  6. by   rdhdnrs
    Yes, that is an appropriate dose for the early IUFD. I have given 200mcg q 4 hrs for 2 days before. The cervix starts out closed and thick but will usually dilate pretty suddenly and delivery will occur. We have had good luck with Cytotec for these situations.
  7. by   ShandyLynnRN
    the docs at my hospital dont use cytotec at all... the last IUFD I did involved a prostin insert and some kind of sea weed things that I have never seen before, inserted into the cervix and I guess then they expand and in turn dilate the cervix???
  8. by   OBNurseShelley
    we use cytotec 200mcg every 4 hours for iufd's usually, it takes forever for anything to happen then it does happen suddenly and delivery occurs. we've also used the lamanaria which is the seaweed things but i've not had much luck with them. 800mcg does seem like a lot!
  9. by   ShandyLynnRN
  10. by   shay
    We use cytotec 200mcg q4h for IUFD's, but the sending the pt. home thing is the part I have a problem with. Dangerous. Even with a small baby, you can still have retained products and hemmorhage.