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My
understanding is that the company that makes Misoprostol does not support the
use of it as an induction drug AT ALL. If this is the case, I can only wonder
how an ethics committee can approve any trial using this drug. It is
considerably cheaper than alternatives and is promoted as being kinder to woman
as it is less invasive than insertion of gels. Also there isn't a storage
problem with having to keep it in a fridge, benefits remote areas aimed at
"helping" developing countries, etc.
The
mind boggles,
Megan
They have started using misoprostol here in Australia;
W&CH SA were doing studies in it using women but assured me they would not
be using VBAC women as VBAC is a contra-indication for using the drug.
These were the same people who were/are doing the ACTOBAC trial.
The thing that worries me is they say it is not
suitable and for darn good reason, but then it becomes the norm for nonvbacs
and then over time it starts to be used and whammo! VBAC is once
again endangered not by being a vbac but by mismanagement. A great
number of the studies into the safety of vbac are ones done where induction
drugs such as this is used....and they wonder why Uterine Rupture
occurs!!!
sorry...just venting!!!
Jo
----- Original Message -----
Sent: Sunday, April 18, 2004 11:21
AM
Subject: Re: [ozmidwifery] VBAC
How common is the use of misoprostol for induction in Australia?
I've read it's used quite a lot in the US & that it's used in
abortion in Australia, but all I've seen used for induction (in my 2 years
as a mid student) in Oz is Prostin.
Would love to hear your thoughts/experiences.
Jen
| 20040414-39 Uterine
rupture associated with misoprostol labor induction in
women with previous cesarean delivery - European Journal of Obstetrics and Gynecology and
Reproductive Biology , vol 113, no 1, March 2004, pp
45-48 Aslan H; Unlu E; Agar M; et
al - (2004) |
| |
OBJECTIVE: To review our experience with
uterine rupture in patients undergoing a trial of labor with a
history of previous cesarean delivery in which labor was induced
with misoprostol. STUDY DESIGN: A retrospective chart review was
used to select patients who underwent induction of labor with
misoprostol during the period from February 1999 to June 2002. Women
with a history of cesarean delivery were retrospectively compared
with those without uterine scarring. RESULTS: Uterine rupture
occurred in 4 of 41 patients with previous cesarean delivery who had
labor induced with misoprostol. The rate of uterine rupture (9.7%)
was significantly higher in patients with a previous cesarean
delivery (P<0.001). No uterine rupture occurred in 50 patients
without uterine scarring. Women with a history of cesarean delivery
were more likely to have oxytocin augmentation than those without
uterine scar! ring (41% versus 20%; P=0.037). CONCLUSION:
Misoprostol induction of labor increases the risk of uterine rupture
in women with a history of cesarean delivery. (16 references)
(Author)
| Article Type: |
Original research |
|
Yet VBAC women are still being induced this
way. 4 out of 41 is pretty definite.
M
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