Drug helps expel remains after failed pregnancy

[Radio_Lady]

24 Aug 2005 21:20:57 GMT

Source: Reuters

By Gene Emery

BOSTON, Aug 24 (Reuters) - The G.D. Searle and Pfizer Inc. drug Cytotec is almost as effective as surgery for removing tissue that can remain in the uterus after a failed pregnancy, a test released on Wednesday has shown.

The drug, also known by its generic name misoprostol, had a success rate of around 85 percent, said Jun Zhang of the National Institute of Child Health and Human Development, the chief author of the study.

The treatment, which can be done on an outpatient basis, is less risky than surgery and the pills costing up to 50 cents can be inserted into the vagina at home, he told Reuters.

The results "show that this treatment may be an option that is preferable to surgery for some women," said Beverly Winikoff in an editorial in the New England Journal of Medicine, where the study appears.

About one in four women will have a spontaneous abortion or some other type of failed pregnancy. If some tissue is left in the uterus, doctors may advise waiting up to a month so it can be expelled naturally, but that does not always work.

For women who don't want to wait, the traditional alternative has been a D&C, which stands for dilation and curettage and involves a surgical scraping of the uterus. A newer technique uses a vacuum to clean the uterus.

To see if Cytotec, which causes uterine contractions and is given after the abortion pill RU-486, is a safe and acceptable alternative, the Zhang team gave it to 491 women who had residual tissue after their pregnancies failed.

They found that it worked in 71 percent of the women by the third day. The remaining women got a second 800 microgram dose, and the success rate increased to 84 percent by the eighth day. The surgery was successful in 97 percent of the 161 who received the vacuum technique.

Eighty-three percent of the Cytotec recipients said they would recommended it to women in the same situation.

"The drug is quite effective," Zhang said. "It usually takes effect in four hours, when you have uterine contractions and the crampy abdominal pain comes. After that, usually the abdominal pain will disappear quickly."

There can be side effects such as some nausea, diarrhea and vomiting.

Winikoff, president of the Gynuity Health Projects in New York, said questions persist about the best dose to use and whether the cause of the failed pregnancy should influence the dose.


Link for the rest of this article:

http://www.alertnet.org/thenews/newsdesk/N24461945.htm

[benburch]

1. Nice labeled use...

Of course, the off-label use is likely inducing an abortion...

[Radio_Lady]

3. Gynecologists, like mine, are using the drug to soften the cervix prior

to inserting the hysteroscope. I'm 66 years old and not pregnant.

Finding this article today was an accident. I had never heard of this drug prior to a few weeks ago. My doctor plans to use it on me next November prior to a planned uterine polypectomy.

Perhaps it will make things go easier -- although there are cases cited where pregnant women have had their uterus ruptured and they died.

Off label use of drugs is the norm today, isn't it?

[KittyWampus]

4. thanks for posting. and the photo in your signature is stunning.

[Radio_Lady]

6. {{Blushes deep red}} Well, thank you very much.

It's the last photo taken of me when I was working a bunch of years ago. The company paid for the photo after I had won a sales award. They put it in a company newsletter.

I should update the photo sometime but haven't bothered -- no reason to do that. I still look pretty much like that, but my hair is not permed anymore. Curls are just too expensive, unless you have them naturally!

Again, I appreciate the compliment!

[KittyWampus]

7. good luck with your procedure.

[Radio_Lady]

12. Thanks so much... "cryingshame"...

[Justitia]

2. My poor sister had a miscarriage & it took almost 2 months for her body

to finally clear itself of the pregnancy remnants.

This was psychological torture for my sis, who really, really wanted the pregnancy. She could have used something like this.

[Radio_Lady]

5. Well, hopefully it will soon be marketed for this purpose.

Too late to help your sister. Hopefully she will happily carry to term in a subsequent pregnancy. One thing I learned after raising animals; better off a miscarriage than having to deal with a malformed baby. Nature often knows best.

I had a stillborn baby in 1960 -- she died inside of me at about 5 1/2 months and I delivered much later (the doctors didn't bother to tell me the baby was dead!). The psychological pummeling under these circumstances is much more difficult than the actual delivery.

[Justitia]

9. Happy ending for sis, now mom to 2

although she did have another miscarriage before the 2 kiddos came along.

I am shocked by what you experienced! The fact that the doctors kept this from you and allowed you to continue the pregnancy absolutely floors me!

I'm so sorry you went thru that, and that you need medical intervention today.

All my best wishes for success and a speedy recovery.

[fleabert]

8. this drugs labeled use is for ulcers.

then dr's noticed it caused uterine contractions in pregnant women who were taking it. so they started experimenting, without consent of thier laboring patients- using the drug to induce labor in women without ulcers. this led to this warning being added to the drug:

http://www.fda.gov/cder/foi/label/2002/19268slr037.pdf
(won't let me cut and paste)

it is still used as an induction drug. They finally got the dosage to where it didn't cause uterine rupture, most of the time. But to get there, it was all trial and error, on unsuspecting women.

if they found this new use to be so effective, just imagine what it might do to a normal laboring woman, trying to give birth.

google 'cytotec induction' and see what comes up.

this is the first one I got, and it's great. (and I found it after I wrote the above information!)
http://www.midwiferytoday.com/articles/cytotec.asp

I am all for getting cytotec out of the labor room, and put it to more effective, safe use.

[yo-yo-ma]

13. NOT TRUE

"all trial and error, on unsuspecting women" . . .

I don't know where you got this information from but there are hundreds of studies (peer-reviewed, IRB approved) on cytotec as an induction agent (look at PubMed not google).

The reason for the FDA warning is because it was pressured by anti-choice groups -- not based on medical science. For this reason it will never be labeled for obstetrical uses.

Cytotec is cheap and stable at room temperature (doesn't need to be refrigerated) and can be delivered without an IV all making it an ideal medicine to use in third world circumstances where it can help in managing post-partum hemorrhage which is the leading cause of maternal mortality world wide.

[OKthatsIT]

10. hmmm....it sounds scary and 'too poor for medical attention'

also...it could be a bad drug.

And the ethics of the drug could be fodder for the Right, especially if it's cheap and done at home. The RW would love for this type of drug to fail or be discredited ...hell, they could be intensionally issuing a deadly drug like this, to drive their point.

If women are not watched closely, they could bleed to death..and with so many women not on medial insurance, many will not go to the hospital if something goes wrong.

I am a ProChoice Feminist. Women need medical attention, not given a pill and told to go home and expell tissues. My God, they've just had a miscarraige...they should be watched for depression and medical probems.

[fleabert]

11. hear hear!

women are often given this drug and then sent home to wait for labor to start, in a healthy full term pregnancy. It's crazy.