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3rd Trimester
Induced with Cytotec?
Hi folks,
I'm officially past my due date (9/28) and my doctor has scheduled me for inducement this Thursday. When we talked to him about how that actually works, he said that I'll be given the drug Cytotec. He warned us not to be scared by some of the stuff written on the internet, but after doing some research, I'm feeling a bit worried. I've been 2 cm dilated and 50% effaced for over 2 weeks now, but things seem to have stalled and the baby's estimating at close to 9 pounds, so in his words, "it's time to jump start the little guy". I'm fine with that, but a bit worried about what I've now read about the drug, Cytotec. This is my 1st baby, so no prior C-section or anything, but still would love to hear if anyone else's Dr. plans to use this or if anyone has had an experience with it.
Thanks!
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Re: Induced with Cytotec?
I would not be induced with cytotec:
https://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm111315.htm
https://www.midwiferytoday.com/articles/cytotec.asp
There are other safe options and I would recommend demanding one that is approved for pregnancy.
When I was pg last time, my midwife and I discussed possible induction techniques just so that we'd be prepared if the need arose. I did a bunch of reading and came down on the side of not wanting Cytotec, and she was comfortable with that. Other possible avenues are inserting a cervical "ripener" like Cervidil and giving that time to work, then starting a low dose of Pitocin if necessary. I would ask your doc about what else you can do if you don't want to Cytotec.
As for my reasons for not wanting to use it, First, it's not FDA-approved for inductions, so using it as an induction drug is an "off-label use." That's not always bad, but it does mean that the manufacturer hasn't had to prove that it's safe or effective for inductions, which makes me nervous. Second, there have definitely been questions raised about its safety (some of which you probably came across in your research). Third, some hospitals won't allow it. That, in and of itself, is a bit creepy.
IMO, if your doc has to tell you "not to be scared of what you read on the internet" about a drug, then maybe that drug isn't something you want to take. True, the internet isn't always right, but if there's enough stuff out there that he's had patients get scared and refuse to take it, then maybe there's something substantively true to all the stuff you read. At the very least, I'd have another conversation with your doc now that you've done some reading.
Good luck!
This - if you're not comfortable with it tell him NO! I also would not allow a Cytotek induction
I was induced with cytotec last year at 21 weeks and I don't know if it was the amount they gave me, but the side effects were MISERABLE.
And when I read that the drug isn't FDA approved for inductions, I was effing livid. Everything I read just said it's used because it's a cheap and fast working option... but to me the risks do not outweigh the purported speed. I'd be asking about prostglandin gel or cervadil instead if you do have to be induced.
I was induced with Cytotec and had no problems. One dose brought labor on fast, but not rushed. I, like most, would prefer not to be induced, but I would probably opt to use Cytotec again if I was given the option. Yes, there are horror stories about lots of drugs out there. Go with your gut, and if you feel Cytotec isn't right for you ask for something else. Cervidel and Pitocen are both drugs that can be used as well.
Anyway, just wanted to let you know that there are many, many Cytotec inductions that are successful and problem free. It is widely used by many hospitals. (I delivered in one of the biggest birthing hospitals in the US)
Best of luck!
My doctor gave me Cytotec to induce my m/c. Granted, it's a bit different than inducing a full term labor, but it did work quickly. I agree that the side effects were pretty gruesome, but I can't compare it to what an induced labor would/should feel like with other treatments.
Either way, do your research, talk to your doctor about any concerns you come up with, and the two of you can decide if it's the best course of treatment or if something else would be better for you.
I think I covered a lot of this in a reply to a post about induction yesterday, but I'll offer this info again:
First, your doctor is right - don't believe the hype. Cytotec (misoprostol) is safe and effective for induction of labor. You don't need an FDA indication to prove that. Instead, you can find nearly 20 years of evidence in the medical literature that it works, it's cost-effective, and has no higher adverse event rate than Cervidil (check out a recent meta-analysis published in the American Journal of Obstetrics and Gynecology here). A recent lit search on PubMed.org revealed a number of papers published this year alone on the efficacy of misoprostol in comparison to other agents. My hospital uses Cytotec, on average, for about 50% of inductions - which I doubt we would do if it was causing serious adverse events routinely.
Second, the ACOG guidelines warn specifically about the use of Cytotec in patients who have previously delivered via c-section - not all patients. It should also probably be avoided in patients with a shorter interval between pregnancies. A good physician would heed these warnings and avoid its use in this type of situation.
Third, an FDA Medwatch alert does not a bad drug make. Many, many drugs receive Medwatch alerts based on post-marketing reports of adverse events. Are there reports of uterine rupture with misoprostol? Yes. But the case reports are hardly numerous and a study published in 2009 puts the risk for uterine rupture with misoprostol use for late-term abortion in women with a history of c-section (some of the highest risk patients) at less than 0.3% Again, when patients are carefully selected for its use, misoprostol is quite safe for the purpose of labor induction - and in invaluable tool in the management of post-partum hemorrhage.
If you are worried about the use of Cytotec for your induction, talk to your provider in depth about these concerns. If you'd prefer he use another agent, I'm sure he can come up with alternatives for you.