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Re: Cytotec From: Raymond Stephen (stephen.raymond@dhhs.tas.gov.au) Fri May 12 06:03:09 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Raymond Stephen: "Re: Cytotec" Previous message: GA12L@aol.com: "Re: Cytotec" Maybe in reply to: rmodugno@aol.com: "Cytotec" Next in thread: Raymond Stephen: "Re: Cytotec" It is noted that the Guideline you refer to was printed in 2001, and that the recommendations at the end are as follows: * Vaginal misoprostol appears to be a more effective induction agent than either intravaginal or intracervical PGE2 or oxytocin. * Misoprostol is significantly cheaper than currently recommended PGE2 preparations. * The safety issues concerning the use of vaginal misoprostol are unclear. * Further clinical trials are warranted in order to evaluate further the issues of safety regarding the use of vaginal and oral misoprostol for induction of labour using commercially produced low-dose tablets. Does the following case mean that Oxytocin should not be used in pregnant women? Uterine rupture in VBAC with oxytocin Unknown County (Mich) Circuit Court After a prior caesarean delivery, a woman and her physician agreed to deliver her second child by caesarean if she did not deliver by a certain date. In the event of earlier labour, she would have a 4-hour trial of labour. She went into labour before the due date and was given oxytocin. During labour, which extended more than 4 hours, the uterus ruptured, resulting in hypoxic ischemia for the infant, who was born with mild learning disabilities. Steve ________________________________ From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of -- ________________________________ GA12L@aol.com Sent: Friday, 12 May 2006 8:12 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Cytotec In a message dated 12/05/2006 10:34:32 GMT Daylight Time, el@lisse.NA writes: Why don't you ask one of your FRCOGs. They will surely appreciate your ignorance. Well, el, it's like this. We don't use Cytotec PGE1 for IOL because that's not what it was intended for. We use Prostin PGE2. Neither the MHRA, RCOG or the makers of Cytotec advocate it being used for IOL. Has the American equivalent of the MHRA the FDA approved it for use to induce labour? Or is it classed as an 'off-label' drug? If not are women told that Cytotec is not approved for inducing their labour? The RCOG substantial Evidence-based Clinical Guideline Number 9 - Induction of Labour' devotes a complete chapter to misoprostol and suggests that "There are safety aspects of misoprostol that have not been fully evaluated and it is not currently licensed for obstetric use. Its use must therefore be restricted to RCTs." If, and it's a big if, a doc here wanted to use Cytotec for IOL he or she would be told in no uncertain terms by the midwives to give it to the woman him or herself. We would refuse to give it for IOL. Gail Next message: Raymond Stephen: "Re: Cytotec" Previous message: GA12L@aol.com: "Re: Cytotec" Maybe in reply to: rmodugno@aol.com: "Cytotec" Next in thread: Raymond Stephen: "Re: Cytotec"

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