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Re: Termination of pregnancy with Hemabate From: Lynn D. Montgomery, M.D. (apgar10@montanadsl.net) Tue Oct 11 11:09:55 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: doctorjoe@aol.com: "Re: Unusual surgical problem" Previous message: Andrew Folley: "Re: Termination of pregnancy with Hemabate" In reply to: dmecnm@aol.com: "Termination of pregnancy with Hemabate" Next in thread: Robert J. Carpenter, Jr. MD: "Re: Termination of pregnancy with Hemabate" Reply: Robert J. Carpenter, Jr. MD: "Re: Termination of pregnancy with Hemabate" First, studies have shown no significant increase in efficacy over using Cytotec 400 mcg orally every 3 hours. Second, the cost for hemabate is amazing (like $800 per 250 mcg). Third, there are two basic ways to use Hemabate in this picture; the first is to use 250 mcg every 4 hours and the second is to use 10 amps as a one time intraamniotic instillation. For the later, I would not attempt it unless you have an individual who is very adept at this sort of thing and confirms intraamniotic position by first infusing saline. I have had excellent success with Cytotec, but I pretreat the cervix with laminaria and this certainly facilitates the process. Lynn -- Lynn D. Montgomery, M.D. Maternal-Fetal Medicine, OB/GYN Rocky Mountain Women's Health 2835 Fort Missoula Rd., Suite 304 Missoula, Montana, 59804 406-549-0978 fax 406-549-0987 e-mail: apgar10@montanadsl.net _____ From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of dmecnm@aol.com Sent: Tuesday, October 11, 2005 9:19 AM To: Multiple recipients of list OB-GYN-L Subject: Termination of pregnancy with Hemabate Question came up in resident sign outs today. Any information would be greatly appreciated. G2P1001 22 weeks gestation with multiple anomalies. Admitted for termination of pregnancy. Cervix long and closed. Cytotec, multiple doses, given over the last 24 hours, with no change in cervix. Attending has ordered hemabate be given. We do not have a policy regarding hemabate in this situation. Anyone have any information? Protocols? Anecdotal stories? Thanks, Denise, CNM So Cal Next message: doctorjoe@aol.com: "Re: Unusual surgical problem" Previous message: Andrew Folley: "Re: Termination of pregnancy with Hemabate" In reply to: dmecnm@aol.com: "Termination of pregnancy with Hemabate" Next in thread: Robert J. Carpenter, Jr. MD: "Re: Termination of pregnancy with Hemabate" Reply: Robert J. Carpenter, Jr. MD: "Re: Termination of pregnancy with Hemabate"

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