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Re: Cytotec, cervical ripeningFrom: Betsy Hyde (elishyde@connix.com)Sat Apr 8 22:33:43 2000
here's where the oldsters will separate from the youngsters. Maybe. Or maybe the oldsers won't remember buccal pit... :) Buccal pit was withdrawn from the market because the FDA said it was unsafe. It was used in-patient and out-patient. The criticism was that one could not control the delivery of the active compound, because this tiny little tablet was just tucked into a mucous membrane. What am I missing? Why is misoprostol ok, but buccal pit unsafe? We've had primips go from 1-2 cm to 8 cm in 15 minutes, and to delivery 30 minutes after that. We've had multips who, dear god in heaven,have "missed their epidurals" because they have gone from unripe to fully on next exam an hour later. These women were really, really mad. We do a very conservative 25 mcg pv. Although fetal outcomes have been shown to be unchanged, I would really like to know if there have been studies on patient satisfaction w/ misoprostol induction. In our patient population, there are many unhappy campers.
-- Betsy Hyde CNM Branford, CT
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