Labor Inducing Drug that Can Cause Uterine Rupture during Delivery
Injury lawyer Laura Brown discusses Cytotec and birth injury.
Cytotec is a drug that is used to initiate labor; it’s in order to ripen the cervix to get the cervix, the women’s cervix ready for delivery. And so, Cytotec used in this way is an off label use, it’s not the use that was intended for the drug, but it is commonly used like that.
And it’s inserted up next to the cervix and allows the cervix to get ready for labor. Then when labor is induced, another drug called Pitocin, Pitocin is given to cause the uterus to contract. Well, what has been known in medical science for a number of years, is that women who have had a cesarean delivery before, have a scar in their uterus from the cesarean delivery, but then when those women later want to try to have a baby vaginally, it’s called a VBAC (Vaginal Birth After Cesarean Section), the use of Cytotec and Pitocin increases the risk that a woman who is a VBAC will have a uterine rupture, which is very dangerous for the mother and the baby. The uterus rips open and the baby can be extruded out of the uterus and it can cause the baby to not get enough oxygen to his brain; it can cause a very serious birth injury.
Another potential contributing cause of uterine rupture is the drug Cytotec (misoprostol). Cytotec (misoprostol) is a drug manufactured by Searle and approved by the FDA to treat stomach ulcers. Many hospitals and doctors utilize Cytotec in an “off-label” use to induce labor, because misoprostal causes the cervix to ripen and thin.
As a result of the increasing off-label use of Cytotec by doctors delivering babies, the manufacturer sent a letter to doctors in August 2000 advising them that Cytotec was not approved for labor induction. There are significant concerns about the safety of using Cytotec for labor induction.
In 1999, the American College of Obstetrics and Gynecologists (ACOG) published a Committee Opinion warning that there had been reports of uterine rupture when Cytotec had been used in labor induction in patients with a prior uterine scar—like VBAC (vaginal birth after Caesarean) patients.
Cytotec causes the uterus to contract and may cause contractions that are too frequent or are too forceful. Contractions that are too frequent and forceful can cause uterine rupture, particularly in VBAC deliveries because the uterus is weakened by the uterine scar.
ACOG stated its position that Cytotec was not recommended for cervical ripening in patients that had a prior Cesarean delivery or other major uterine surgery.
Fortunately, uterine ruptures are not common for mothers who have not previously had a C-section. Because the risk is greater in VBAC deliveries, medical providers must be very careful to monitor for signs and symptoms of uterine rupture. The baby’s heart rate must be continuously monitored for any abnormalities that may suggest the baby is not receiving enough oxygen from the mother. Other symptoms may include abdominal pain, vaginal bleeding, signs of shock, rapid pulse, etc.