Database - Alliance francophone pour l'accouchement respecté (AFAR)

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Created on : 25 Jul 2004
Modified on : 02 Dec 2007

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Bibliographical entry (without author) :

Cytotec Induction and Off-Label Use. Midwifery Today, 67, Fall 2003.

Author(s) :

Wagner, Marsden

Year of publication :

2003

URL(s) :

http://www.midwiferytoday.com/articles/cytotec.asp

Résumé (français)  :

Abstract (English)  :

Doctors find it difficult to admit mistakes. Here we have a big mistake—Cytotec induction with VBAC—that went on for years. Yet, there is no discussion of the error or what to do so it won’t happen again.

Those doctors and midwives using Cytotec for induction of labor off-label need to understand that they are taking very big chances with the safety of the women and babies they serve. Just about everyone in the world, after taking a careful look at the scientific evidence, has concluded we don’t yet know enough about the risks to be willing to use it. This is illustrated in the following list of organizations that do and do not recommend Cytotec (misoprostol) for labor induction:

Recommends

1. American College of Obstetricians and Gynecologists (ACOG)


Does not recommend

1. U.S. Food and Drug Administration
2. Best scientific opinion—Cochrane Database
3. Searle (manufacturer of Cytotec)
4. Society of Obstetricians and Gynaecologists of Canada
5. British Royal College of Obstetricians and Gynecologists
6. All obstetric organizations in Scandinavia
7. FIGO (International Federation of Gynecology and Obstetrics)
8. World Health Organization
9. Obstetric organizations and drug regulatory agencies in many other countries


How can ACOG possibly be willing to stand alone in opposition to the best scientific opinion in the world? Because so many of ACOG’s members already use Cytotec induction off-label for its incredible convenience, the organization needs to support its members by recommending this practice. This means ACOG must find a paper published in a prominent U.S. journal supporting Cytotec induction. In ACOG’s recommendation on Cytotec induction, the organization leans heavily on a paper by A.B. Goldberg and other authors published in the New England Journal of Medicine (2). Let’s take a careful look at the contents of this paper, as it is a superb example of torturing the data until it confesses to what the authors want it to say…

Sumário (português)  :

Comments :

Argument (français) :

Les médecins ont de la difficulté à reconnaître leurs erreurs. Or celle-ci est de taille: le déclenchement des accouchements vaginaux après césariennes à l’aide du Cytotec (misoprostol), recommandé par l’American College of Obstetricians and Gynecologists, qui persiste depuis des années…
Doctors find it difficult to admit mistakes. Here we have a big mistake -- Cytotec induction with VBAC -- that went on for years.

Argument (English):

Doctors find it difficult to admit mistakes. Here we have a big mistake -- Cytotec induction with VBAC -- that went on for years.

Argumento (português):

Keywords :

➡ vaginal birth after caesarean ; c-section/caesarean ; induction of labor ; misoprostol (Cytotec) ; physiology ; post-term pregnancy

Author of this record :

Bernard Bel — 25 Jul 2004