We use 25mcg of Cytotec vaginally for inductions. My question is does ky jelly decrease its effectiveness?
Oct 19, '01
That's awfully kind. We don't use anything.
Oct 23, '01
Kristina girl, your posts crack me up!
Oct 29, '01
Whenever I have used cytotec, I crush it up into almost a powder and mix it with a little K-Y, I then lubricate my glove with this mixture and I have found that it works just fine. We only use cytotec for very early (less than 20 weeks) fetal demises. The only problem that I can see with this is that it would be very hard to retrieve if pt hyperstims. On a related note, when placing cervidils, I have found that if I put the cervidil between my fingers and then put a little K-Y on the opposite sides of my fingers, the cervidil stays in a little better. (ya know how it always tries to follow you out!!) I hope this helps.
Oct 30, '01
Doesn't crushing release all the med at once, increasing the odds of hyperstim?
Oct 31, '01
I would think that it would; I'd be afraid to crush the pill. Has anyone seen any studies or protocols about this?
Nov 6, '01
When I crush the cytotec, again, we are only using it for <18 week demises and, I failed to mention, we only use 1/4 or less of a tablet at a time. I have never had a problem with hyperstimulation.
Nov 6, '01
We use .25mcg of cytotec for full term inductions, and we NEVER crush the pill.
Nov 10, '01
I have heard of many different ways of inducing a demise w/ cytotec. some places have them take a large oral dose then start vaginal doses. First time hearing about crushing it. I have seen usually .25-.5mcg q 4hrs, sometimes it takes a while.
Nov 10, '01
oh. forgot something on the KY discussion. What about speculum exams. I hate doing them without any lube but they say it can give a false + for srom. Sometimes i'll have them insert it themselves. I think here they would freak if they knew you were putting warm water on a sterile speculum although there would probably be no real harm.
Nov 12, '01
For a sterile spec exam, try room-temp sterile water.
The surgi-lube DOES produce a false positive nitrazine, but that's not entirely reliable anyways for r/o SROM. Blood and urine also turn it positive.
Look for ferning instead.
Nov 15, '01
Thx. We on an admit exam we usually do all 3 (nitrozine, pooling, ferning and an SVE). Jared
Nov 16, '01
Most of our providers use Cytotec 50 mcg vaginally for inductions. Occasionally, some of them use 50 mcg p.o. if the patients cervix is really favorable. For fetal demise, we usually use Cytotec 100-200mcg. At our hospital, we have a Cytotec consent form that pt's are required to sign prior to cytotec use. The form basically states that cytotec is not approved for use in Obstetrical patients for induction of labor. Does anyone else have such a form at their hospital?
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