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Cytotec (misoprostol) is a synthetic medication acting as an analogue of prostaglandin E1. Prostaglandin E1 is a substance, normally present in human body, which has a protective effect on gastrointestinal tract, especially the stomach. Food and Drug Administration (FDA) approved misoprostol to be used for prevention and management of gastric ulcer and gastritis caused by overuse of some drugs that damage gastrointestinal mucosa, such as non-steroidal anti-inflammatory drugs (NSAIDs). Besides this indication, misoprostol is also used off-label in obstetrics and gynecology, especially for inducing medical abortion.

Medical Abortion With Cytotec

The FDA hasn't approved Cytotec for use in obstetrics, but since 2002, doctors can prescribe this drug off-label if they consider to be the most preferable way of ending a pregnancy in particular cases. After oral, vaginal, rectal, or sublingual administration, Cytotec displays its effects by binding to myometrial cells (muscle cells of the uterus), which causes strong contractions. These contractions are supposed to expel the embryo/fetus from the uterus, along with the superficial layer of uterine mucosa, thus ending the pregnancy. This process is always accompanied with painful cramps and bleeding from the uterus. Other side effects include diarrhea, nausea, vomiting, and fever.

If medical abortion with Cytotec is unsuccessful, it is necessary to perform another attempt with a combination of different drugs or surgical abortion. The pregnancy should not be continued due to possibility of congenital anomalies caused by this drug.

Cytotec is prescribed for the purpose of medical abortion after a complete examination and assessment of pregnancy status by a gynecologist.

All additional factors must be taken into consideration, such as heart or kidney disease, coagulation problems, the possibility of extrauterine pregnancy, allergy to misoprostol, previous cesarean sections, etc. If contraindications are not excluded prior to administration, this drug can have very detrimental consequences, including tearing of the uterine tissue, uncontrolled bleeding, and even death.

In women with negative Rh factor, Rh immunoglobulin needs to be administered along with Cytotec in order to prevent miscarriage of future pregnancies.

Cytotec After Miscarriage

If, for any reason, pregnancy is spontaneously terminated in the early stage (before the 12th week), your doctor may recommend Cytotec to help expel residual tissue from the uterus. A single dose of orally, vaginally, or sublingually administered drug is usually enough for this purpose. This approach is preferable to a surgical curettage, due to a lower risk of infection and damage to the uterine wall.

Use Of Cytotec For The Treatment Of Postpartum Hemorrhage

The final stage of labor, which comes after the birth of the baby and placenta, involves strong uterine contractions. This stage is necessary in order to stop bleeding from the torn uterine blood vessels. In some women, this process is either too slow or the contractions are weak, so it requires medical intervention in order to prevent fatal bleeding. There are many drugs called uterotonics that induce uterine contractions and are commonly used for this purpose. However, their effectiveness is not always 100 percent, and Cytotec can be used as additional or alternative agent.

In summary, Cytotec has wide use in gynecology and obstetrics, even though it is not approved by FDA for those indications. Use it only under full supervision of your gynecologist. Over-the-counter use of Cytotec is not recommended as it can have fatal consequences.

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