Wednesday, February 13, 2008

Stop the Misuse of Cytotec to Induce Labor

Some would say this is old news, but the topic still hasn't gotten the attention from the US populace as it should so I'm writing about the dangers of Cytotec induction.

Cyotec is a drug developed for repair of stomach ulcers developed by the pharmaceutical company Searle. The company placed a warning on the label stating it is contraindicated for use in pregnant women as it can cause uterine contractions, leading to preterm labor. The obstetrical community put two and two together and thought, “Hey, we could use this to induce labor! Let’s try it.” So they did. No studies or trials to see the effects. They just started doing; often without the consent of their patients.

The active ingredient of Cytotec is the hormone misoprostol which when inserted into the vagina in capsule form softens the cervix and hastens dilation. Strong contractions are also brought on. Because the drug is being used against label it is hard to determine proper dosing. OBs are using the high tech method of cutting capsules into smaller pieces. Also, once inserted the capsule can not be removed so deleterious effects cannot be stopped or reversed once too high a dosage is given.

The FDA got wind of it and issued warnings to the American College of Obstetrics and Gynecology who in turn told OBs that Cytotec should not be used to induce labor, especially not in women who have previous had a C-section; instead recommending that every women who has had a prior C-section have another. But that’s another post all together. (For risks of C-sections see What They Don’t Tell You About C-sections) However, use of Cytotec for inductions is still commonplace in many hospitals across the county.

Off-label (or more appropriately against label) use of Cytotec in pregnant women can lead maternal or fetal death, uterine hyper-stimulation, rupture or perforation requiring uterine surgical repair, hysterectomy or salpingo-oophorectomy, amniotic fluid embolism, severe vaginal bleeding, retained placenta, shock, fetal bradycardia and pelvic pain. The risks of this happening spike dramatically if the woman has already had a prior C-section.

An example of a death caused by Cytotec induction is Tatia Oden French who was induced at the age of 33 with her first child. The Cytotec caused hyper-stimulation of her uterus that could not be reverses, leading to her uterus rupturing and ultimately her death as well as the death of her child during emergency surgery.

Her family started the Tatia Oden French Memorial Foundation to prevent this misuse of the drug from killing or harming other mothers and infants.

The foundation also started an online petition to the FDA to cut down on doctors known to be use the drug despite its warnings and contraindications.

Please sign the Petition


Anonymous said...

I would just like to share my experience. I found out that I had miscarried at 11.5 wks. My OBGYN recommended the insertion of this pill (Cytotec) and allowing my body to take care of things vs. a DNC. I later had a 2nd miscarriage later and was scheduled (by a different OBGYN) for a DNC right away. Had I known better I would never have let this woman talk me into using Cytotec. I was told that I would experience "a crescendo of bleeding"and was sent on my way. Well, I went on to later go into full blown labor. Regular, painful contractions, terrible back pain, near constant bleeding. I was white as a sheet and terrified as to what was happening to me...again, I was in no way prepared for what I experienced. I considered a trip to the ER, but I was bleeding so much I couldn't get off the toilet long enough to go anywhere. I spent 5 hours in my bathroom, on the toilet. Physically it was painful and frightening and emotionally it was devastating. I wouldn't wish it on my worst enemy. I am shocked to find out about all of this literature is/has been presented to these physicians and yet they continue to use it for this purpose anyway. I will be eternally grateful that I didn't suffer any permanent damage from this ordeal and am now just 12 days away from delivering my first baby. Obviously I found a new OBGYN.

Anonymous said...

nMy daughter, was eagerly awaiting the birth of her first child. She did everything she could to ensure a safe, healthy start of life for her child. She ate the right foods, attended prenatal classes with her husband, exercised, went to all her scheduled OBGYN checkups....she wanted a natural birth. At 41 weeks her doctor strongly suggestd an induction. My daughter and her husband listened to the doctor... After a few doses of a labor inducing agent..,,her labor finally started. She gave birth to a healthy child,,,but then my daughter started hemmoraging and suffered an AFE. She passed away a few hours later.
Months later we learned she was given Cytotec...a drug NOT approved by the FDA for labor inducement.and its a drug with serious life threatening risks atached to it. My daughter and her husband were not given this information!! They were such a 'natural couple,,,and wanted a natural birth,,THEY NEVER WOULD HAVE AGREED TO A DRUG WITH SUCH SERIOUS RISKS!! NEVER!!
Cytotec is used natiowide for labor inductions and is often the drug of choice......usually no problems... But educate yourselves and decide..
Tell your sisters, daughters,and all the young women in your life about cytotec. Ask your health provider questions, Know the risks, know your options, dont assume the doctor will tell you. Educare yourselves. Then decide if you think cytotec is right for you. I implore everyone to sign the petition. Your loved ones will be protected. The black box warning needs to be reinstated No family should have to endure the pain our family and others have because of the misuse of Cytotec.

Jenne said...

Thank you for sharing your experiences and I'm so saddened by your losses. My heart goes out to you.

Anonymous 1, have you heard of Solace for Mothers? It sounds like your experience could have been very traumatic and had long last emotional effects. Solace is for women who have experienced trauma relating to childbearing.

Anonymous 2, I just can't understand why doctors feel its okay to hide the known risks from their patients. Its is unethical to not disclose the risks because when false information is given, consent is not truly informed and its not really consent. Hiding the risks is a form of manipulation and coercion. So thank you for the warning to patients to not trust doctors to tell you impartial evidence for a particular treatment option.