Re: Cytotec and postpartum hemorrhage
From: Terrence.Jones@kp.org
Thu Jul 17 15:25:48 2003
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Think the meds were available (Elmendorf AFB). Think they just
didn't want to use hemabate with asthma hx (more a precaution than
contraindx), nor methergine with inc bp. Have seen cytotec work well here,
but limited numbers... If still open (ie: atony) there's always"B-Lynch"
(BJOG 3/97; with modification: O/G 3/02) along with foley tamponade
(Danso, BJOG 8/02). "Rare association" of cytotec with
bronchospasm/dyspnea - tho no causal association either confirmed or
negated. OTOH, one gets a certain degree of dyspnea as the HCT drops into
the 'teens'. tj
eramirezt@coqui.net (Efrain Ramirez)
Sent by: ob-gyn-l@obgyn.net
07/17/2003 12:29 PM
Please respond to ob-gyn-l
To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
cc:
Subject: Re: Cytotec and postpartum hemorrhage
Haven't heard it is contraindicated in asthmatics - !
If there is no Hamabate - you can use it - rectally or/and PO - I dont
think it is as good as Methergine or Hemabate.
At Thu, 17 Jul 2003, Braun, R. Daniel wrote:
>
>Cytotec is also a prostaglandin. Can't use in asthmatics either.
>
>We use it after C/S. It is our second choice after pitocin.
>
>-----Original Message-----
>From: Glen Elrod MD [mailto:glen.elrod@elmendorf.af.mil]
>Sent: Thursday, July 17, 2003 10:41 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: Cytotec and postpartum hemorrhage
>
>Does anyone have any experience with Cytotec and postpartum hemorrhage
>in women that have just undergone a c-section. I know that Cytotec is
>contraindicated in women with a previous c-section for labor induction.
>I have used cytotec rectally for women with vaginal deliveries that have
>postpartum hemorrhage.
>
>The reason this came up is we have a postpartum c/s that is diabetic,
>asthmatic, preeclamptic with a postpartum hemorrhage. Methergine is
>out. Hemabate is out. Pitocin was running. Pt is now several hours
>out from surgery. Any other suggestion?
>
>Thanks,
>
>Glen
>
>--
>D. Glen Elrod, Maj, USAF, MC
>Medical Director
>Women's Health Clinic
>Elmendorf AFB, AK 99506
>
--
"The opposite of a correct statement is a false statement.
But the opposite of a profound truth may well be another profound truth."
Niels Bohr (1885 - 1962)
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<br><font size=2 face="sans-serif"> Think the meds were available (Elmendorf AFB). Think they just didn't want to use hemabate with asthma hx (more a precaution than contraindx), nor methergine with inc bp. Have seen cytotec work well here, but limited numbers... If still open (ie: atony) there's always"B-Lynch" (BJOG 3/97; with modification: O/G 3/02) along with foley tamponade (Danso, BJOG 8/02). "Rare association" of cytotec with bronchospasm/dyspnea - tho no causal association either confirmed or negated. OTOH, one gets a certain degree of dyspnea as the HCT drops into the 'teens'. tj</font>
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<td><font size=1 face="sans-serif"><b>eramirezt@coqui.net (Efrain Ramirez)</b></font>
<br><font size=1 face="sans-serif">Sent by: ob-gyn-l@obgyn.net</font>
<p><font size=1 face="sans-serif">07/17/2003 12:29 PM</font>
<br><font size=1 face="sans-serif">Please respond to ob-gyn-l</font>
<br>
<td><font size=1 face="Arial"> </font>
<br><font size=1 face="sans-serif"> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net></font>
<br><font size=1 face="sans-serif"> cc: </font>
<br><font size=1 face="sans-serif"> Subject: Re: Cytotec and postpartum hemorrhage</font></table>
<br>
<br><font size=2 face="Courier New">Haven't heard it is contraindicated in asthmatics - !<br>
<br>
If there is no Hamabate - you can use it - rectally or/and PO - I dont<br>
think it is as good as Methergine or Hemabate.<br>
<br>
At Thu, 17 Jul 2003, Braun, R. Daniel wrote:<br>
><br>
>Cytotec is also a prostaglandin. Can't use in asthmatics either.<br>
><br>
>We use it after C/S. It is our second choice after pitocin.<br>
><br>
>-----Original Message-----<br>
>From: Glen Elrod MD [mailto:glen.elrod@elmendorf.af.mil]<br>
>Sent: Thursday, July 17, 2003 10:41 AM<br>
>To: Multiple recipients of list OB-GYN-L<br>
>Subject: Cytotec and postpartum hemorrhage<br>
><br>
>Does anyone have any experience with Cytotec and postpartum hemorrhage<br>
>in women that have just undergone a c-section. I know that Cytotec is<br>
>contraindicated in women with a previous c-section for labor induction.<br>
>I have used cytotec rectally for women with vaginal deliveries that have<br>
>postpartum hemorrhage.<br>
><br>
>The reason this came up is we have a postpartum c/s that is diabetic,<br>
>asthmatic, preeclamptic with a postpartum hemorrhage. Methergine is<br>
>out. Hemabate is out. Pitocin was running. Pt is now several hours<br>
>out from surgery. Any other suggestion?<br>
><br>
>Thanks,<br>
><br>
>Glen<br>
><br>
>--<br>
>D. Glen Elrod, Maj, USAF, MC<br>
>Medical Director<br>
>Women's Health Clinic<br>
>Elmendorf AFB, AK 99506<br>
><br>
<br>
--<br>
"The opposite of a correct statement is a false statement. <br>
But the opposite of a profound truth may well be another profound truth."<br>
<br>
Niels Bohr (1885 - 1962)<br>
</font>
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