It's pretty clear the cytotec causes more uterine contractions when given orally - typically beginning to act in 10 mintues. However, it has a longer acting effect when given vaginally or rectally, but doesn't kick in for 25 minutes. I think it's a great second line for hemorrhage, but pitocin is more physiologic and acts in a few minutes. But it's way better than methergine, IMO.
If it were being given for induction, I like the protocols that call for a tablet to be dissolved into water first, then portioned out. So, a 1/4 tablet dose is 25 ml of water after one tablet is dissolved into 100 ml of water. At least then the dosing is actually what is ordered, instead of cutting a tablet with no score lines.
I've never heard of it being given for ectopic pregnancy - only methotrexate. Misoprostol would cause uterine contractions - I can't think of a mechanism to expel an ectopic, but that isn't my area of expertise.
I do think it should be an option for induction. When a mom needs to be delivered for maternal health reasons, but is long and closed, cytotec can get the baby out vaginally. I don't think it should be used for "general" inductions for postdates or convenience. Lots of things are dangerous, but used in moderation in pregnancy. If they weren't needed, no one would use pitocin, antidepressants, asthma medications, beta blockers, or seizure medications, either. There's a reason that Lady Justice carries a scale. Maybe medicine needs a scale, too.
I've found one written reference to that particular "procedure" since then, in an OLD copy of the dreaded "What to Expect..." but they've since edited it out. Go figure.
Anyway. From personal experience...I certainly wouldn't recommend it. That's not statistical, I know, only anecdotal, but thank you to the pp who mentioned the fact that it was used for her post partum to stop a bleed. I'd be interested to hear of more experiences from the recipients.