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Re: Cytotec for induction (was RE: IUD/Abruption)From: R. Daniel Braun (rBraun@IUNET.IUPUI.EDU)Thu Jun 6 07:04:46 1996
There once was an agent for inducing labor that was very effective. It only required a shot once every 4-6 hours and really induced labor nicely. I was called "Sparteine" It was around for a while, then it was discovered that it worked too good and on occasion caused uterine rupture and even tetanic contractions. I mention this because the discussion of "Cytotec" reminds me of this. I hear people saying "don't use it in people with prior Cesarean" Why? because it may cause uterine rupture. Why might it cause uterine rupture in these patients ????? Maybe because it causes contractions that are too good. Why do patients have a rapid active phase ???????? Maybe because it causes contractions that are too good. IMHO anything that is a contraindication to labor in a patient with a prior cesarean (Low transverse) is a contraindication to labor. On another point, in this country, we have an interesting phenomenon at work. How do you get the OB community toi uses a drug ? You take a drug that happens to have an obstetrical action and find another indication for it, then you market it for that other indication. After that the OB's in the US start using it for the non indicated OB indication and take all the risk. In fact the reason they will use it is that it is cheaper than another similar drug that has been approved, which costws more only because it was approved for the obstetrical inciation(thanks to the cost of the studies to get the approval.). e.g. Terbualine and Ritodrine.
-- @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ R.Daniel Braun, MD FACOG "Money will buy you a fine dog, Clinical Professor but only love will make it wag Dept. OB/GYN it's tail." Indiana U. School of Medicine Richard "Kinky"Friedman Racetown @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@
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