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Re: Cytotec for induction (was RE: IUD/Abruption)From: Armando Fuentes (afuentes@onetinc.com)Wed Jun 5 22:10:18 1996
SAVARIS@vortex.ufrgs.br wrote: > > Coyote, > Dr. Meyer gave a nice protocol in the list, but the idea is that you dont need > to used pitocin and citotec. The patient will enter in spontaneous delivery in > most of the cases. You may repeat every 12 hours the tablet into the cervix, > not into the vagina. I prefer this instead of just put into the vagina. The gel > is just a vehicle to dissolve the tablet, because, most of the times the tablet > fell off the vagina or from the cervix. > > Again, do not USE CITOTEC in third trimestre with previous C-section, the risk > of uterine rupture is increased. > > Ricardo Savaris > savaris@vortex.ufrgs.br > > PS.:You may find an article made from a group from Florida, in the American > Journal of Obstetrics and Gynecolgy, 1992, september, I guess. We currently have several studies involving cytotec in our institution. To date, no significant complications have been encountered. It is very important to note that it can be used as an abortifacient (200 mcg), as a cervical ripening agent (25-50 mcg) or to induce labor at term (25-50 mcg). I cannot suggest any protocols, since we are currently investigating the drug. I also would not encourage the use at term until all the data is evaluated. D.Mishell's study in the NEJM has helped its use in delivery of 2nd trimester fetal demises. We have included patients with prior c/s and to date, no abnormal outcomes have been encountered. I believe the low cost will promote its use. We still need to find the optimal dose for cervical ripening. A.Fuentes Div. Maternal Fetal Med Arnold Palmer Hosp Orl, FL afuentes@onetinc.com
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