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Cytotec Induction and Birth Injuries

Doctors sometimes use medications such as Cytotec to induce labor in pregnant women, especially when they are more than one to two weeks past their due date. While Cytotec can stimulate contractions and help dilate the cervix, using it poses risks to the mother and baby. The FDA warns against using Cytotec during the childbirth process. Birth Injury Center explains what you need to know about Cytotec induction, including its side effects and risks.

Pregnancy complications can make it necessary for doctors to induce labor with medications such as Cytotec. This medication can encourage contractions, making it easier to deliver the baby. However, Cytotec induction carries certain risks to mother and child, ranging from uterine ruptures to seizures and even fetal or maternal death.

The U.S. Food and Drug Administration has strict warnings against using Cytotec for labor induction, but some doctors continue to use the medication. Its wide availability and affordability make it attractive to physicians and patients. However, patients may be unaware of the dangers of Cytotec if the doctor doesn’t explain them.

If you suspect Cytotec caused you or your baby harm, speak with a qualified attorney at the Birth Injury Center. One of our birth injury lawyers can review your case and determine your legal options.

What Is Cytotec?

Cytotec is a brand-name version of misoprostol, a synthetic form of prostaglandin. The body produces natural prostaglandins that help regulate certain bodily processes, including blood clotting, inflammation, healing, and menstruation. Synthetically produced prostaglandins can treat various ailments, including erectile dysfunction and glaucoma.

The FDA has approved Cytotec to prevent stomach ulcers in people who take nonsteroidal anti-inflammatory drugs, or NSAIDs, such as aspirin or ibuprofen.

However, the FDA disapproves of using Cytotec for labor induction, cervix softening, or decreasing blood loss. It issued an FDA alert warning of the potential side effects of Cytotec for those purposes, which can be severe. However, some doctors continue to use it during the birthing process.

What Is Cytotec Used for in Pregnancy?

Cervix ripening is a natural bodily process that precedes birth, but some women need medical assistance. Doctors sometimes use Cytotec as a medicine to soften the cervix or induce contractions in pregnant women. A doctor may decide to use Cytotec if you have a late-term or overdue pregnancy or certain health risks, such as preeclampsia.

They may also use it to stem blood loss following childbirth. Sometimes, women experience severe bleeding after childbirth, known as postpartum hemorrhage. Postpartum hemorrhage is a dangerous condition requiring immediate treatment. Cytotec can help stop bleeding if the cause of the hemorrhage is uterine atony, the failure of the muscles to contract.

Why Do Doctors Induce Labor?

Doctors induce labor for several reasons, including the following:

  • You’re more than one to two weeks past your due date.
  • Your water breaks, but contractions don’t begin.
  • You have certain health conditions, such as high blood pressure, preeclampsia, or gestational diabetes.
  • Your baby’s fetal weight is below the 10th percentile.
  • You have a uterine infection.
  • You’re in labor, but you’re slow to dilate.
  • You experience placental abruption, which occurs when the placenta separates from the uterine wall.

Inducing labor may reduce the risk of medical complications during childbirth, including birth injuries.

How Is Cytotec Given for Induction?

Doctors who use Cytotec to induce labor typically insert the medication into the vagina, though it may also be taken orally. They give patients a low dose of 25 mcg and wait to see if the drug ripens the cervix and begins contractions.

Some patients may receive higher or additional doses of Cytotec if the doctor believes it’s necessary. However, higher doses increase the risk of side effects to the mother and fetus.

How Long Does It Take Cytotec To Work for Induction?

Cytotec can take between 30 minutes and six hours to start working. If the desired effects don’t occur, doctors will provide an additional dose every three to six hours until labor begins.

What Are the Risks of Cytotec?

There are multiple risks involved in using Cytotec to induce labor, ripen the cervix, or stop bleeding following delivery:

  • Overly frequent uterine contractions
  • Uterine rupture
  • Amniotic fluid embolism, which causes cardiovascular collapse
  • Low fetal heart rate
  • Meconium staining, which can cause lung problems and infection in the baby
  • Maternal shock or death
  • Fetal death
  • Increased heart rate
  • Seizures

If the baby has poor blood flow due to complications from using Cytotec, they may suffer infant brain injuries. Brain damage can lead to severe conditions, including hypoxic-ischemic encephalopathy or cerebral palsy.
Despite the risks, some doctors continue using Cytotec during childbirth. If you’re pregnant, it’s essential to ask your obstetrician if they administer Cytotec and discuss the risks involved if they do.

What Are the Side Effects of Cytotec?

The most common Cytotec side effects include uterine cramps and contractions, diarrhea, and pain in the abdominal region.

Other Cytotec side effects include:

  • Inflammation of the uterine lining
  • Pelvic inflammatory disease
  • Heavy bleeding
  • Constipation
  • Nausea
  • Indigestion
  • Dizziness
  • Headaches
  • Fever
  • Skin rash

The risk of side effects increases with higher doses of Cytotec.

Man holding the palm hand of a pregnant woman in labor

Who Is at Greatest Risk From Cytotec?

Patients at the most significant risk of complications from Cytotec include:

  • Those who previously underwent uterine surgery
  • Those who had a prior delivery via C-section
  • Those with multiple prior births

Pregnant women who meet any of the high-risk criteria for Cytotec should not take the medication.

Is Cytotec Approved for Inducing Labor?

No, the FDA has not approved Cytotec for labor induction. In fact, the FDA issued an alert specifically advising against the use of Cytotec for labor induction. The FDA cites the severe risks that may occur with the drug, including a torn uterus. If the uterus tears during childbirth, the mother may require a hysterectomy. A torn uterus can lead to the death of the mother and her baby.

While the FDA disapproves of using Cytotec during or after childbirth, it’s not illegal for your doctor to do so. Doctors may use a drug for so-called off-label treatments as long as the medication has FDA approval for treating any condition.

Can I Choose a Different Medication Than Cytotec?

Yes. One alternative to Cytotec is oxytocin, which trades under the name Pitocin. Pitocin is FDA-approved for labor induction, cervix ripening, and stopping post-childbirth bleeding. However, there must be a medical reason to use Pitocin.
Other alternatives to Cytotec and Pitocin include the Foley and Cook catheters. Catheters inserted into the urethra can help stimulate the cervix and encourage dilation. Catheters don’t require any medication, but they may be less effective.

Cytotec vs. Pitocin

Cytotec and Pitocin can induce labor, ripen the cervix, and stop post-delivery bleeding. However, Pitocin is FDA-approved for those usages, while Cytotec is not.

Pitocin has similar risks and side effects to those of Cytotec. The chances of complications increase when doctors use higher dosages. The most common side effect is uterine hyperstimulation, which can lead to fetal heart deceleration.

Unlike Cytotec, the FDA has not explicitly expressed concerns about the risk of a torn uterus when using Pitocin. However, there are some reports of uterine rupture and fetal distress.

Pregnant woman with a doctor

Seek Legal Help if Cytotec Has Harmed You

While doctors commonly use Cytotec in childbirth, the FDA doesn’t approve its use in pregnancy. Some women may feel pressured to use the drug, especially if they encounter problems during or after labor. Often, they don’t understand what to expect after a Cytotec induction, particularly if they’re in pain or suffering through a difficult birth.

If you encountered moderate or severe side effects from using Cytotec, you may be able to recover compensation. A skilled attorney at Birth Injury Center can evaluate your case and help you determine your options.

Contact us today to schedule a free consultation and avoid missing out on the compensation you deserve.

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Written by:
Birth Injury Center Team

The Birth Injury Center aims to create informational web content and guides to help women and their families seeking support and guidance for birth injuries caused by medical negligence. All of the content published across The Birth Injury Center website has been thoroughly investigated and approved by medical expert Natalie Speer, RNC-OB, Attorney Ryan Mahoney, and Attorney Rick Meadows.