As a legal nurse consultant who has also been a labor & delivery nurse for more years than I care to count, I review many medical malpractice cases where the underlying issue is Cytotec. For those of you who do not work in labor & delivery, Cytotec is also known as Misoprostol and was FDA approved for gastric ulcers many years ago. It is also an effective drug when used properly for the induction or augmentation of labor which is also known as "off-label use".
The problem with Cytotec often occurs when obstetrical caregivers become complacent with its use. First, they seem to forget that Cytotec's use in obstetrics is not FDA approved for that purpose. T
his creates controversy surrounding the use of the drug and liability issues when careful scrutiny is not taken to ensure the indication for its use in obstetrical practice is consistent with current standards of care. Nurses must realize they will have to answer serious questions at deposition regarding the indication and monitoring of patients who have received Cytotec for induction or augmentation purposes.
his creates controversy surrounding the use of the drug and liability issues when careful scrutiny is not taken to ensure the indication for its use in obstetrical practice is consistent with current standards of care. Nurses must realize they will have to answer serious questions at deposition regarding the indication and monitoring of patients who have received Cytotec for induction or augmentation purposes.Next, Cytotec is widely used in obstetrics primarily for its ability to produce rapid labor progression. It is often referred to in obstetrical circles as "Cytoblast" which offers an indication of how the drug can effect labor progression. Nurses should always be aware of the role this drug plays in uterine contractions and the response of the fetus to it. Close monitoring of the fetal heart tracing as well as contraction pattern should be maintained after administration of Cytotec.
Third, Cytotec should never be used for induction or augmentation on pregnant women who have had a previous cesarean section. The risks of uterine rupture creating significant liability issues are far too great. Nurses should also question physicians who order Cytotec with an admitting dignosis of a "non-reassuring fetal heart rate". This could also create liability issues down the road if the outcome is not good. For any other questions or concerns regarding the use of Cytotec in labor, you may contact us at 1-877-347-6557 or email at mcook@cook-legalnursing.com.
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