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Pregnancy After Cytotec

post #1 of 10
Thread Starter 
Hi - I wasn't sure where to post this and decided this might be the best place. In August of 2002 my baby died in utero at 20 wks. I was given cytotec to induce labor. I have been trying to unsuccessfully to get pregnant again for almost a year.

I was reading a article "Real Risks Revealing the Risks Obstetrical Interventions and Maternal Mortality" in the recent issue of Mothering May/June 2003. I have read other articles about cytotec and it's dangers and complication, however I was unaware it could cause problems with getting pregnant after it's use.

This article is not about cytotec but makes a brief reference to it. And maybe I am misunderstanding the quote but it says "New scientific data show that inducing labor with Cytotec causes a marked increase in uterine rupture, an obstetric catastrophe in which a quarter of all babies die, many women die as well, and , OF THE WOMEN WHO SURVIVE, ALMOST NONE CAN EVER HAVE ANOTHER BABY."

The last part concerns me. What is this saying? Do woman who are given Cytotec without complications have problems getting pregnant later? or is this statement just referring to woman who do have complications with Cytotec?

I plan to discuss this and fertility issues at an up-coming OB appointment I have, but I have become so concerned about this statement I can't wait till then.

If anyone who knows of woman who were given Cytotec and then had another baby I would love to hear about that to put my mind at ease.

Also if there is a better board for me to get this answered please direct me there.

Thanks
post #2 of 10
That statement means that of the women who survive the uterine rupture, almost none can never have another baby. It doesn't refer to all women who were given cytotec. That is true of any woman who suffers uterine rupture, regardless of whether or not cytotec was used to induce labor. Unfornutately, it is being used quite commonly in some areas. I had to put in writing before my last child was born that I would sue the hospital if they gave me cytotec for any reason, even if I was unconcious.

I don't know if there are fertility issues beyond that in regard to cytotec. That is some scary stuff.
post #3 of 10
The article is not saying there are fertility issues after the use of cytotec. It is stating that there are fertility problems (or actually, more like pregnancy problems) with women who have had a uterine rupture. The article is merely expanding on the fact that the uterine rupture rate with cytotec is higher than without, and that consequently, issues with subsequent pregnancies are more likely to occur.

We selectively use cytotec, and have never had any issues regarding fertility (nor, for that matter, rupture or hypertonicity of the uterus). I know there are many who believe that cytotec can never be used safely. But, there are two sides to every issue, and I just wanted to briefly present the other side.

If you want to read more discussion on cytotec, I suggest you search the archives. I have argued for the selective use of cytotec before; but I'm not up to doing it every time cytotec comes up! : I wouldn't have time to do anything else!

Briefly, though, strictly and medically speaking, cytotec (aka misoprostol and miso, if you are every looking for it in your records) is for cervical ripening. That is what we call it; but everyone knows it is an induction method.

No one should every be given *any* medication or intervention without consent, miso included. Nor should the risks be glossed over. And no medication or intervention has *no* possible side effects. And you never *have* to do something; you can always refuse, no matter what environment you are in.

Lori
post #4 of 10
Thread Starter 
An update. I have been much reassured. Both by the posts here and on another board where I posted this. Thank You. I have now heard back from both a OB and a Midwife both saying Cytotec doesn't cause problems after it's use unless there is a complication during it's use such as uterine rupture.

I do think woman should be informed of the risks and facts involved with Cytotec before being given it so they can decided for themselves. If woman were able to make informed decisions about the use of Cytotec it would make it harder for others to blow the side effects out of proportion. Everything has side effects the important part is to know what they are and the percentages involved. I was surprised to find out that Cytotec has been approved in Europe for induction.

Something can sound horrible and then you find out it has a 1% chance of happening it doesn't sound so bad anymore. I have no idea what the percentages of problems are with woman and their babies who have used cytotec I don't even know if research has been done on this. For example the article said about 1000 woman die a year around the time of birth and they believe that number is less than what it really is. The article states that we are rated 15 in the world in maternal mortality, but it never gives what that rating is. I don't know the number but when you think about the number of births that must occur in the US every year that number of woman who die is pretty small. And yes it would be great if no one had to die while giving birth, but I would imagine if we look at history going way back many less woman die now than even did 100 yrs ago.

I am not saying we shouldn't be informed and concerned the article definitely has some merit, but with out the exact percentage of maternal mortality given, I personally think it over inflates the problem.


thanks,

Pam & Noah 9/11/99
post #5 of 10
Rupture is the least common thing that can happen, but fetal distress is more common.

True, many women do not get informed choice. They are not told about the risks at all. That is sad. That is one reason why the rate of obstetric litigation is so high in our country.

Which European country has approved Cytotec? I was unaware that it was being used for induction of labor at term with any blessings.
post #6 of 10
Thread Starter 
About Cytotec in Europe, I asked my source to elaborate on Cytotec's use in Europe. She said her information was for restricted medical sites and suggested I look at a couple of other sites. And I did some web searches of my own. I was unable to find any clear information but what I did find indicated that cytotec is used in Europe much the way it is here in the US but has been approved for use in abortions, which is essentially what I had done, even though the baby had already died. I am assuming since my source was replying directly to my situation that's what she was referring to.

I also found that induction itself carries a risk of about 5% chance of complications and that the chances of complications from cytotec is less than 1/2%. I know from experience that if you are in that 5 or 1/2% the fact that your chances of it happening are very small is not very comforting. Cytotec seems to be very controversial both in the US, Canada and Western Europe and the research seems to be lacking and confusing. There is some research that suggests that cytotec can help to avoid c-sections.

At this point personally I am just glad I didn’t have complications and am glad to know it is probably not the reason I haven't gotten pregnant yet.
post #7 of 10
You won't find the data on Cytotec's safety or risks because the studies just haven't been done. If they had been, and showed a definite risk, the FDA would step in and say it ought not be used to induce. As it is approved as an ulcer medication, they can get away with using it for other uses until it's safety has been questioned by the results of a formal study. Tricky tricky tricky.

All I know is my own personal experience with it. I was not even told they were giving it to me, much less informed of the risks!
My baby's heartrate dropped from 160 to 10 beats per minute as a result, and was immediately surgically extracted from my belly. Everyone I know in real life who was given Cytotec ended up with an "emergency" c-section.
post #8 of 10
Sounds like your question was answered already...but just as an FYI...my OB perscribed cytotec to help me miscarry naturally in August '01 (it was my choice to not have a D and C)...weeks went by and there was no further development in the FOUR gestational sacs I carried...loss was at about 6 weeks-no heartbeats. Anyway, to help things along naturally, she gave me Cytotec and I recall that I had to take more than one dose to really get things going. I bled a lot as most of the tissue had already reabsorbed.

Now have a healthy 5 month old.
Best Wishes to you and Hugs for your loss.
post #9 of 10
Studies have been done; I'll have to look through our files. None, though, were done prior to the widespread use of cytotec, which is really shameful. However, studies are showing that it is safe *with judicious use, within certain parameters* well, at least as safe as pitocin.

Of course, if the standard of care weren't that women shouldn't go overdue, this debate would likely be fairly moot.

Somewhat off topic (my apologies to the OP!):

We have used cytotec with about 50 women over the last 3-4 years. Some were to induce labor when the baby had died in utero, and the mom did not go into labor within a couple of days. Mostly for moms approaching 42 weeks. We don't set these parameters; ACOG and NACC do. If we "let" someone go overdue without attempting to get labor going (and they don't accept accupuncture, accupressure, chiropractic work, sex, or castor oil as attempts) and a baby died, the state could sue us, even if the parents didn't want to, for practicing outside of the standards of care. If this weren't the way our system is, I doubt very much we would have any issue with most moms going 42+ weeks. It really stinks.

We have never had a rupture or hypertonicity (we do have Brethine at the bedside in that event). Moms with a recent history of asthma and moms with previous uterine surgery can't be given cytotec; it is too risky. Labors DO seem to go alot faster, and I think they are much more intense, by the mom's response. It is harder for them to deal with the contractions, since it is artificial. We have never had to transport because of fetal distress, but that could also be because we don't break the bag of waters, like most practitioners do when inducing.

We have also not noticed a drop in fertility in women after the use of cytotec, to reassure you. I would also add that we have a one page consent that women must sign before we begin the cytotec, outlining our dosage and protocols, and the potential side effects of cytotec, including rupture, hypertonicity, fetal death, hemorrhage, hysterectomy, etc. We hold no punches. We tell women to look on-line, and we have the mothering magazine article available for them. We also have the medical articles discussing cytotec available for them. Some women refuse the cytotec, and that is totally okay. But if they go over 42 weeks, they can't have their baby at our facility (state and NACC rules, not ours); most choose the cytotec over a hospital birth. They are between a rock and a hard place, no doubt about it. And it is completely unfair.

Instead of crying out against cytotec, I wish that those who vehemently vilify its usage would instead turn their passion and energy to changing our medical and legal system. So what if cytotec is banned for use as a cervical ripening agent? Something else will be found and used in its place. Instead, change the rules we have to operate within. Why should women be forced to have their baby by 40 weeks? Why must labors procede within a certain time frame? Why must women be monitored so closely during labor that they are constrained in their movement? Why are epidurals pushed? Why can't doctors spend more than 5 minutes per prenatal with their patients? Why aren't midwives more accepted, especially when they don't act like little OBs?

Our medical and legal systems are sick, and they are dictating how women are being treated, or not treated. If these things would change, the entire issue of cytotec, pitocin, even c-sections would be moot, as they wouldn't even be issues. Pipe dreams, probably. But boy, wouldn't that be the day, when women were treated with respect and dignity? When they could be partners in their care, and all their wishes could be honored, without the fear of state-sponsored litigation and possible jail time? I hope that this exists for my daughters.
post #10 of 10
I've used cytotec. Below may be a little graphic

At 15 weeks it was found my baby had died some weeks before. (2) After waiting another 4 weeks, my body showed no signs of beginning the miscarriage. Taking my husbands stress levels, my anxiousness and the whole families well being, we opted to use the cytotec.

My research, speaking to different OB, looking on line, was that me taking cytotec was safer than me going in for a D&C with no contractions as that has a higher risk of perferating the uterus. If the cytotec only started contractions and no m/c at least the OB would be able to perform the d&c more easily.

Now here is where I've heard things like "well your body was reabsorbing the fetal tissues, there was no need to rush things", "you could have waited, it would have happened."

I took only one dose of one pill and bleeding commenced within 20 minutes, just spotting. A couple of hours later contractions started, mild like menstrual cramps. Just before I was due to take the next dose I felt a *pop*, I went to the washroom, where I had a bucket waiting, and as I crouched over it, i delivered my baby. He was perfect. I was able to take the time to count fingers and toes. I could see a wee little penis, the most perfect little nose, tiny mouth, and dainty ears. He was pale, but otherwise would be a baby you'd see on discovery channel in utero. He was perfect.

My body wasnt reabsorbing the baby, baby was stil in the amniotic sac. Who knows how long it could have gone on. It enabled me to spend time with a baby that I had wanted so bad. I d&c wouldn't have. And time didn't seem to make any difference.

i did end up with a d&c as i bled alot, but there was no complications.

That was alittle over a year ago. Today I'm sitting her 34+ weeks pregnant. My fertility wasn't affected at all.
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