Re: Maternal deaths, and risk of misoprostol for missed AB
From: Dr. Rupak Ranjan Roy (rupakroy1@dataone.in)
Sat Mar 18 20:44:37 2006
--Boundary_(ID_Qxf2jYWbvm5tzMKsUMoARA)
Content-type: text/plain; charset=iso-8859-1
Content-transfer-encoding: QUOTED-PRINTABLE
More literature on the issue:
N Engl J Med 2005; 353:2317-2318, Dec 1, 2005
Dr. Rupak Ranjan Roy
MRCOG
> ----- Original Message -----
From: fran wilson
To: Multiple recipients of list OB-GYN-L
Sent: Sunday, March 19, 2006 3:18 AM
Subject: Re: Re: Maternal deaths, and risk of misoprostol for missed AB
Below is the press release from Planned Parenthood. It still appears to me that the drug suspected to have caused the problems is the vaginal misoprostol. Of course, there are many who would like to relate it to the "abortion pill." I am wondering about the location of the most recent two deaths. The first four were all in California, there is no mention about which clinic or which location, and the next two occurred close together but there has been no mention of location. I wonder if it is less related to the method than to some other variable that is related to that specific bacteria, such as fecal colonization. I wonder if there have been any cases of PP sepsis that can be tied to vaginal administration of Cytotec?
Fran Wilson, CNM
Kennewick, WA
"Our health centers will no longer recommend the option of administering misoprostol vaginally (misoprostol is the second drug in the two-drug medication abortion regimen). Patients will now receive misoprostol orally or buccally (where the pill is placed between the cheek and gum and dissolves). This change in protocol is effective immediately." "Our health centers will no longer recommend the option of administering misoprostol vaginally (misoprostol is the second drug in the two-drug medication abortion regimen). Patients will now receive misoprostol orally or buccally (where the pill is placed between the cheek and gum and dissolves). This change in protocol is effective immediately."
----------------------------------------------------------------------------
--------------------------------------------------------------------- From: <igold@cox.net>
--
--------------------------------------------------------------------- Reply-To: ob-gyn-l@obgyn.net
To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
Subject: Re: Re: Maternal deaths, and risk of misoprostol for missed AB
Date: Sat, 18 Mar 2006 12:22:26 -0600
Actually, if you read the link Fran sent, it infers that misoprostol is the problem. I actually heard on the NPR report that this was the case also. Ingrid
>
> From: "Gerald P. Rodríguez" <geraldpr@cybermesa.com>
> Date: 2006/03/18 Sat PM 01:17:24 EST
> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
> Subject: Re: Maternal deaths, and risk of misoprostol for missed AB
>
> Today's Wall Street Journal reports that Planned Parenthood in Washington DC
> said yesterday that it was changing its prescribing practices for the use of
> MIFEPRISTONE (Mifprex) (RU-486) in light of two recent maternal deaths
> associated with its use vaginally instead of orally. Its vaginal use is
> off-label and this practice is now being implicated in the death of 6 total
> patients from sepsis.
>
> Gerald P. Rodríguez, M.D., FACOG
> Santa Fe
>
> ~~~~~~~~~~~~~
> Quien calla otorga.
> ~~~~~~~~~~~~~~
> ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
> > ----- Original Message -----
> From: <igold@COX.NET>
> To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@dns.obgyn.net>
> Sent: Saturday, March 18, 2006 9:58 AM
> Subject: Maternal deaths, and risk of misoprostol for missed AB
>
> > In light of the recent news linking maternal deaths to use of vaginal
> > administation of misoprostol, what do you think of continuing its use for
> > missed AB? Do you think oral administation would reduce the risk? Why?
> > From what I understand, 6 maternal deaths have now been attributed to
> > vaginal use of misoprostol (my sources are NPR driving home from work last
> > night, and this morning's Arizona Republic newspaper) Thanks, Ingrid Gold,
> > CNM, Phoenix
> >
>
--Boundary_(ID_Qxf2jYWbvm5tzMKsUMoARA)
Content-type: text/html; charset=iso-8859-1
Content-transfer-encoding: QUOTED-PRINTABLE
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN">
More literature on the issue:
N Engl J Med 2005; 353:2317-2318, Dec 1, 2005
Dr. Rupak Ranjan Roy
MRCOG
> ----- Original Message -----
Sent: Sunday, March 19, 2006 3:18
AM
Subject: Re: Re: Maternal deaths, and
risk of misoprostol for missed AB
Below is the press release from Planned Parenthood. It still
appears to me that the drug suspected to have caused the problems is the
vaginal misoprostol. Of course, there are many who would like to relate
it to the "abortion pill." I am wondering about the location of the most
recent two deaths. The first four were all in California, there is
no mention about which clinic or which location, and the next two occurred
close together but there has been no mention of location. I wonder if it
is less related to the method than to some other variable that is related to
that specific bacteria, such as fecal colonization. I wonder if there
have been any cases of PP sepsis that can be tied to vaginal administration of
Cytotec?
Fran Wilson, CNM
Kennewick, WA
"Our health centers will no longer recommend the option of
administering misoprostol vaginally (misoprostol is the second drug in the
two-drug medication abortion regimen). Patients will now receive misoprostol
orally or buccally (where the pill is placed between the cheek and gum and
dissolves). This change in protocol is effective immediately." "Our health
centers will no longer recommend the option of administering misoprostol
vaginally (misoprostol is the second drug in the two-drug medication abortion
regimen). Patients will now receive misoprostol orally or buccally (where the
pill is placed between the cheek and gum and dissolves). This change in
protocol is effective immediately."
From: <igold@cox.net>
Reply-To:
ob-gyn-l@obgyn.net
To: Multiple recipients of list OB-GYN-L
<ob-gyn-l@dns.obgyn.net>
Subject: Re: Re: Maternal deaths,
and risk of misoprostol for missed AB
Date: Sat, 18 Mar 2006
12:22:26 -0600
Actually, if you read the link Fran sent, it infers
that misoprostol is the problem. I actually heard on the NPR report that
this was the case also. Ingrid
>
> From: "Gerald P. Rodríguez"
<geraldpr@cybermesa.com>
> Date: 2006/03/18 Sat PM 01:17:24
EST
> To: Multiple recipients of list OB-GYN-L
<ob-gyn-l@dns.obgyn.net>
> Subject: Re: Maternal deaths, and
risk of misoprostol for missed AB
>
> Today's Wall Street
Journal reports that Planned Parenthood in Washington DC
> said
yesterday that it was changing its prescribing practices for the use
of
> MIFEPRISTONE (Mifprex) (RU-486) in light of two recent maternal
deaths
> associated with its use vaginally instead of orally. Its
vaginal use is
> off-label and this practice is now being implicated
in the death of 6 total
> patients from sepsis.
>
> Gerald
P. Rodríguez, M.D., FACOG
> Santa Fe
>
>
~~~~~~~~~~~~~
> Quien calla otorga.
> ~~~~~~~~~~~~~~
>
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
> ----- Original Message
-----
> From: <igold@COX.NET>
> To: "Multiple recipients
of list OB-GYN-L" <ob-gyn-l@dns.obgyn.net>
> Sent: Saturday,
March 18, 2006 9:58 AM
> Subject: Maternal deaths, and risk of
misoprostol for missed AB
>
>
> > In light of the
recent news linking maternal deaths to use of vaginal
> >
administation of misoprostol, what do you think of continuing its use
for
> > missed AB? Do you think oral administation would reduce the
risk? Why?
> > From what I understand, 6 maternal deaths have now
been attributed to
> > vaginal use of misoprostol (my sources are
NPR driving home from work last
> > night, and this morning's
Arizona Republic newspaper) Thanks, Ingrid Gold,
> > CNM,
Phoenix
>
>
>
>
>
--Boundary_(ID_Qxf2jYWbvm5tzMKsUMoARA)--
