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View Diary: Sunday Talk - "Fake 'Da Nation" (185 comments)

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  •  Be wary of media playing epidemiologists (4.00)
    We may be getting hoodwinked on this

    Just because the FDA did not study cytotec for labor induction doesn't mean its use for this purpose hasn't been studied.  A 2001 article in the New Enlgand Journal of Medicine concludes (NOTE: misoprostol = cytotec):

    There is also strong and consistent evidence to support the use of misoprostol for cervical ripening before surgical abortion in the first trimester and for induction of labor in the second and third trimesters.

    This does NOT mean its continued use shouldn't be scrutinized. The paper I quote also states:

    There were no differences in the rates of cesarean delivery, serious neonatal or maternal morbidity, or neonatal or maternal mortality between women who received misoprostol and those who received oxytocin or prostaglandin E2 [the then-current standard of care for labor induction]. However, because there were so few serious adverse effects, the relative risk of rare adverse outcomes with the use of misoprostol for induction of labor remains unknown.

    So attention should (continue to) be paid.

    However, also note that cytotec is being used off-label in medical abortions from the first trimester on.  My bigger concern is that these personal tragedies are being used by those looking for any and all excuses to tie the hands of abortion providers.  Making off-label use of drugs during pregnancy illegal could be one such strategy.
     

    America began begins with freedom from King George's empire.

    by bribri on Sat Feb 11, 2006 at 10:52:25 PM PST

    [ Parent ]

    •  The company itself did this (4.00)
      Cytotec's makers won't take responsibility for any labor or abortive use, simply because they don't want it used for abortions.  So I was told by an Ob/Gyn attending last year.
    •  It's been known (4.00)
      for years that Cytotec has been rupturing uteri in labor induction.  But it goes beyond cytotec--is this some kind of sneaky gouge at abortion?

      I've also known plenty of women with c-section scars who were induced for a VBAC . . . also a rupture risk.  That's ignoring standard of care.

    •  Regarding off label use (none)
      as unrelated as it seems, misoprostol has also been shown in several small studies to ease the pain of trigeminal neuralgia when it is caused by multiple sclerosis.
      How a drug that prevents ulcers, causes cervical ripening and so on also quiets the pain in a facial nerve is beyond me. Why they ever studied it for trigeminal neuralgia I don't know. Maybe it was an incidental finding.
    •  Joy, rhbarb, PT, Bri.. (none)
      bribri, Ptolemy, rhubarb, joynow, I really appreciated all the points you've added.

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