Misoprostol (Cytotec), a drug originally created by G.D. Searle & Co. to treat ulcers, has become an increasingly popular, and extremely dangerous method of induction. In the beginning this drug was used with a combination of other chemical treatments as an abortive measure. Since 1992 it has been taken to the opposite side of the spectrum, to the delivery rooms. At this time Cytotec has not been approved by the FDA as an induction drug, but yet it’s use as one has become alarmingly widespread.
Unfortunately, once the FDA approves a drug, such as Cytotec for its’ initial purpose, doctors can use it in any matter that they choose, regardless of whether it has been approved as an induction drug by the FDA. Physicians, finding it a much cheaper and quicker way to induce labor in full term pregnancies, administer the drug on a frequent basis. Since it’s use as method of labor induction, stories of the risks and deaths associated with this drug have become rampant and frightening.
Cytotec, a pill which can be administered orally, or inserted vaginally and placed against the cervix, is usually given in quarter doses. The pill works to soften the cervix, just as other cervix softening agents such as Prepidil and Cervidil do. The dangers of this drug, including uterine rupture, pose a possible threat to all women when used as a method of induction. However, for woman attempting a VBAC (Vaginal Birth After Caesarean), the risk of uterine rupture increases dramatically. One particular study of Cytotec used on VBAC candidates found that eight percent experienced uterine rupture in comparison to the 0.2 percent of other cases where Cytotec was not used.
While it is unknown why Cytotec has such adverse affects on women with prior uterine scarring, perhaps what is even more baffling is why this drug is still being used. From the financial standpoint, doctors find this drug much cheaper than other labor induction methods such as Pitocin which can run hundreds of dollars after the use of an IV for constant administering, continuos Fetal Monitoring, and if the cervix isn’t ripe, a cervix softening gel such as Prepidil or Cervidil. The rapidness in which Cytotec induces labor and softens as well as dilates the cervix is also an appealing factor of the drug, promising delivery usually within the time span of ten to twelve hours after first being administered.
While the risk for a uterine rupture when used as a method of induction in VBACs is higher, the risk is still there for those without prior uterine scarring. Cytotec brings on extremely strong, intensive contractions, which can, as a result lead to a rupture of the uterus, uterine scarring or not. Women who have not had a previous Caesarean should not assume that, with the use of this drug, uterine rupture could not possibly occur.
In some cases, uterine rupture does not occur immediately. Women continue to labor normally, until they experience one of the common symptoms of uterine rupture, including a “popping” sound, severe abdominal pain, or bleeding. Once the rupture occurs, the chances of the fetus surviving are slim, and if survival does occur, the risk of severe neurological damage is staggering as the fetus loses precious oxygen. In other cases, violent contractions can occur after the first dose, and can result in uterine rupture. It is also important to note that the risk of placental abruption can drastically increase for women with prior uterine incisions. If Cytotec is given out of a hospital setting, or when no doctor is present, the results can be fatal.
Unfortunately, the risks associated with Cytotec are not widely known, and most women, undergoing an induction with the use of the drug, are the last to know. Alarmingly enough, the information surrounding Cytotec, when administered for its’ original use, clearly states that any woman who is pregnant or thinking of becoming pregnant should not use it, and should use appropriate birth control to avoid pregnancy during the regimen as it can cause miscarriage or abortion. Yet this drug, with it’s deadly side affects is still used in hundreds of hospitals, by hundreds of doctors, without regard for it’s dangerous potential.