Cytotec and hypotonic uterus

From: Diane Petersen (peter261@gold.tc.umn.edu)
Sun Apr 9 13:53:16 2000

Has anyone used Cytotec per rectum in the postpartum patient with a hypotonic uterus? If so, were other agents used first, second, etc.? Also, what dose of Cytotec was used rectally?

I recently had a patient experience an amniotic fluid embolism. It presented with fetal bradycardia. Crash C/S with no apparent explanation for the bradycardia at surgery. Just before closing the abdomen DIC became apparent and the previously contracted uterus became hyppotonic. Hemabate (four doses in total) did not resolve the hyponia, therefore, subtotal hysterectomy was performed. BTW, loads of blood products were running and blood was starting to clot again but the uterus wouldn't contract. End of story---mom and baby both are okay. 

--
Diane Petersen MD FACOG
Mpls MN
Private Practice



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