Cytotec used rectally for PPH

[mama2be11]

I am not a birth professional but wanted to post this here to get some professional input. I had PPH with my last birth and was given cytotec rectally. I actually didn't even know it until it was already done and everything was happening so fast so I'm not sure I could have stopped them if I tried. Is there any reason for them doing this especially since from what I've heard cytotec is so dangerous? I'm expecting my second and would like to be informed about it this time around in case it were to happen again.

[pamamidwife]

There aren't risks of uterine rupture, and that is one of the risks of Cytotec use, albeit small. The other risks are uterine hyperstimulation (more common) and resulting fetal distress.

These risks only pertain to a full-term labor (Cytotec is also used to expedite an early pregnancy loss without the risk of uterine rupture). Not postpartum.

Cytotec is used for PPH where the bleed does not respond to Methergine, Pitocin or Hemabate. IT is also used first-round for torrential bleeds.

Side effects are common, including diarrhea and/or nausea/vomiting.

[mamato3cherubs]

Almost certain that what you have heard about the dangers of cytotec are associated to its use in assisting with labor induction of a term pregnancy.

These do not apply to pph. It is not the drug itself as a whole that is so dangerous, it is the inappropriate use during pregnancy that is dangerous

[MamaRabbit]

Another side affect for it's use PP is elevated blood pressure. I've seen it 3 times with clients that birth at a hospital that uses it routinely. These mothers had no PPH or risk for it, normal BPs whole pregnancy and birth, given cytotec just because, 3 hours later staff can't figure out what's wrong with the BP. I poked around online and found it to be a side affect.

I don't know why they've chosen cytotec and so routinely - this is a new development in the last year.

[MidwifeErika]

Originally Posted by MamaRabbit

I don't know why they've chosen cytotec and so routinely - this is a new development in the last year.

Do you mean for postpartum? I think it is becoming so common for use postpartumly because it works awesomely and is more stable than pitocin as it doesn't need refrigeration.

[April422]

Originally Posted by hotwings640

Do you mean for postpartum? I think it is becoming so common for use postpartumly because it works awesomely and is more stable than pitocin as it doesn't need refrigeration.

one more important factor, it's cheap.

[mamato3cherubs]

I understad what you are saying MamaRabbit. I understand why they are using it for pph, and the elevated bp may be a risk worth taken for a quick and effective assistance during a hemorage,

BUT you are saying why are they using it for pp routinly when there IS NOT hemorage. really, it is a good question, but I guess I feel the same way about pit immediatly after the birth of the baby. It all comes down to active managment of 3rd and 4th stage rather than expectant management which is more along my ways of thinking.

Now im rambleing...

[mwherbs]

Mamarabbit it might be that they are studying it where you are at- or that there has been a recent policy having to do with lowering maternal mortality - blood loss being one of the preventable causes....

as for how it ends up getting used first or second is that it tends to work faster than pit- and it is stable at room temp- pit needs cool storage or it looses strength- side effects from the studies I looked over -
"The significant side effects in the misoprostol group were shivering, pyrexia (temperature > 38 degrees C) and vomiting, which were self-limiting."
BP increases weren't noted in many of the studies but methergin will raise bp, and can cause diarrhea --- I found one oral dosage study that found mild increase in bp with the use of 600 mcg of misoprostol- but other studies that did not have an increase in bp as an effect-- so maybe how it is given- oral/rectal or sublingual --

[MamaRabbit]

Well this is a private hospital with no studies being done. It's just in the last year or so that everyone is getting it (rectally) regardless of how the birth went. I guess why it's so surprising is because this is a Mother-Friendly hospital with active labor, waterbirths, squatting on the floor births, etc. yet they suddenly are springing this on the mothers

I have no problem with this being used as 1st action against PPH if there really is one. But a mom with 100ml of blood loss? No.