Mysoprostol (aka Cytotec): The Ugly Drug

Bare with me for a moment while I let the steam escape from my ears and the pounding in my chest subsides.

There.

Today, for the second time, I overheard an OB resident order Cytotec to induce a patient. In all of my reading and education thus far nothing pisses me off more than knowing OBs (and some midwives) use this drug on pregnant women WHICH IS NOT EVEN APPROVED BY THE FDA!! Yes. And maybe you were prescribed it. The more common name is Cytotec whose true name is Mysoprostol. This is a common drug used to minimize stomach ulcers as well as to help induce women for whatever reason (see the list below of the MEDICAL reasons for induction). The tiny white pill is inserted into the cervix to help it soften. This is usually followed by Pitocin once 1-3cm dilation has been achieved from Cytotec. It can take anywhere from 6-24 hours for the drug to work and usually around the 12th hour a 2nd dose is given.

I remember learning about this drug briefly in my Bradley class and if I had a choice of Pitocin or Cytotec I’d take Pitocin in a heartbeat. That being said, I’ve never been induced and the only experience I had with Pitocin was after I’d delivered Logan and I was given a small amount to help expel the placenta and minimize bleeding. Cytotec rarely is used after birth but that is not to say some OBs don’t use it.

As with any drug, there are risks and between these two most popular induction drugs their risks are similar HOWEVER Cytotec has had more complications and infant/maternal deaths than Pitocin. The most serious complications include uterine rupture and placental abruption. A women in labor is at an even greater risk of uterine rupture if she has previously had a c-section. The force and strength of the kind of contractions which both Cytotec and Pitocin create can cause the scar tissue to tear easily (hence why VBACs (vaginal delivery after ceceran) are still considered risky).

But why does it make me so upset? For several reasons. I don’t think that the women who are being given the drug are a)informed about the risks and b) told that it’s not even approved by the FDA and doctors still prescribe it. WHY?!! It’s so unnerving to think that the one person we put both our health and our baby’s health into the hands of is even suggesting that a drug is prescribed to “help soften things up” (my words). It’s relatively painless to administer, brings contractions on slowly, helps dilation–why not? Sounds like a nice way to get labor started. I wonder if the doctors who prescribe this know the risks and simply do not feel that there are enough numbers (aka: deaths) to sway them. Nor is the FDA cracking down and flat out denying it to OBs. Seems so upside down and backwards. I am eager to learn more about why this Cytotec continues to be used however I am not yet brave enough to ask the resident I saw tonight.

If you or someone you know is going to have a baby soon and an induction is on the horizon, PLEASE share this info with her. At the very least she will know the truth and can make a decision based on that and not “because my doctor said so”.

FDA link.

Real Life Story (plus many links within)

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