Re: Cytotec
From: art fougner, md (evsono@pipeline.com)
Thu Apr 25 08:02:10 2002
spam - literate spam to be sure but spam nonetheless - time to once
again readdress the concept of the moderated list.
just my opinion - i could be wrong.
art
At Thu, 25 Apr 2002, not.her.again@yahoo.com wrote:
>
>I am a long time lurker to this list, never post as I am not a med pro,
>but I'd venture to say my credentials are as good as a doula's, so I'll
>stop biting my tongue just this once.
>
>>There are numerous, well-designed peer-reviewed journal articles from unbiased physicians documenting the safety of misoprostol when, like all medications, it is used appropriately. >
>
>True enough, based on the existing literature. But how were the
>protocols for appropriate use determined? Through experimentation. That
>means a lot of women and babies were treated inappropriately in the
>quest for the appropriate protocol. In the process of that
>experimentation, some women had ruptured uteri, and some babies died. A
>while ago, an article about Cytotec was discussed on this list. The
>article included the story of a woman (primip) who was induced with
>Cytotec and had a uterine rupture, her baby died, and she had a
>hysterectomy. Not one member of this list expressed compassion for this
>woman's multiple losses. Instead, everyone jumped to defend Cytotec.
>Why can't physicians admit that people are sometimes harmed by
>medicine's quest for new technologies and new treatments? I know, I
>know, it's those circling sharks that make you afraid to stick your toes
>in the water...but still.
>
>>This research suggests that one should not use it if the patient has had major uterine surgery or a prior cesarean delivery, >
>
>Again, the recommendation that it not be used when there has been prior
>uterine surgery was arrived at only after the fact...after thousands of
>women with prior scars were given Cytotec experimentally, increasing
>their risk of rupture. How can you not acknowledge that some babies
>were damaged or died in the process of reaching that recommendation, and
>that that denial really angers some of us outside the profession (and
>some wise folk inside the profession, as well)? Not to mention how those
>who were directly affected feel about it. Who apologizes to these
>families for the fact that their losses were "necessary" in the quest
>for a Cytotec protocol? No one.
>
>>but, when used as part of a formal protocol, this medication is safe and effective. >
>
>Just because the studies are there that show the appropriate "safe"
>protocol doesn't mean all physicians are following them. Many doctors
>and midwives are still using Cytotec inappropriately. Furthermore, I
>haven't yet seen studies documenting the potential long term effects (or
>lack thereof) of Cytotec. If anyone can point me to a study that has
>looked at the impact on the subsequent pregnancy of a previous Cytotec
>induction, I'd appreciate it.
>
>Anyway, sorry to intrude upon your professionals-only forum, but I think
>that this list suffers from a bit of groupthink at times, and perhaps an
>outside perspective is needed when no one in the group seems able to be
>objective. I'll remain anonymous since some of you know me or know of
>me.
--
art fougner, md
ich bin ein New Yorker
