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Re: Compounded prostaglandin gel for cervical ripeningFrom: Gary Kleinman (fuf@ix18.ix.netcom.com)Thu May 28 16:17:43 1998
Ndovu97@aol.com writes: >WHO CARES!!!!! With Pakistan and India and nuclear proliferation, I can clearly see the above perspective. Still, Dr. Montamat poses a reasonable question and this forum should be able to give him some impression of the consensus regarding this issue. Our hospital insists on Cervidil or Prepidil which are the commercial approved preparations, primarily for medicolegal concerns. Our hospital charges the patient $709.00 for a single dose of Cervidil and a Cytotec (misoprostol) tablet costs a patient $1.71. A multitude of studies have attested to the relative safety of vaginal Cytotec in doses of 25-50 micrograms. The smaller dose can be given every 3 hours for 3 doses. The larger dose is given every 4-6 hours. I believe that if informed consent is documented, then there is enought literature to support either the "home made" thereapy or Cytotec with little medicolegal risk. Your obstetricians might not want to use an unapproved preparation, and that policy seems reasonable too. My last hospital used only a homemade preparation of 3 mg of prostaglandin E and Cytotec tablets. There was no clamoring for the pharmaceutical preps. We did have one problem with large 200 microgram tablets of Cytotec which we used for fetal demise only. These take some abrasion with wet gloved fingers or other tricks to dissolve. I hope that answer helps. Gary
-- Gary E. Kleinman, M.D. Perinatologist/Geneticist Perinatal Center 3196 S. Maryland Ave Las Vegas, NV 89109 702 732-9332 702 732-4472 (Fax)
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