[Is it already time to legalize the usage of Cytotec (Misoprostol) in the obstetrics' practice?].
Cytotec (Misoprostol) is a prostaglandin E1 9(PgE1) analogue. Despite that it is not officially registered for obstetric and gynaecological targets, Cytotec (C) is widely used in this sphere. The author aims to study the effect and results from C application used for delivery (birth) induction, as well as means for cervical maturation. In order to reach this aim, beside the group of 45 pregnant women to who we applied C, we also reviewed the existing literature, which reported proves for C efficacy, pharma-kynetics and the safe aspects of its application (usage) in pregnancy.


METHODS
C was used with 45 pregnant women, divided in two groups: I group--27 pregnant women with oral application and II group--18 pregnant women with vaginal application. C was given per os in dosage 50 microg at 4 hours, the maximum dosage being 200 microg. When applied in the vagina, the dosage was twice 50 microg, every 6 hours. Four hours after the second dosage, if the effective delivery activity was not sufficient, we continued with sub-lingual application in dosage 50 microg every 4 hours till the regular delivery activity was reached. The vaginal delivery (childbirth) till the 24th hour of C application is considered as a successful induction.


RESULTS
The delivery (childbirth) continuation, though with insignificant difference, is less under vaginal application. Uterine contractions begin (start) 30-35 minutes earlier under C application. Sectio Caesarea has smaller frequency under C application, in comparison with the general population frequency for the same period (year 2006 and the first half of 2007). The C induction is successful in 40 (88.89%), and with 7 (25.93%) the per oral application was prolonged via oxytocine infusion, and with half of the patients the vaginal application was continued via sun-lingual one. The author reaches the conclusion, that Cytotec is an effective and safe means for delivery (childbirth) induction, and that when dosage and application manner are set-up, the individual characterics of the patients should be taken into account. Mother-fetal results are the best under single dosage of 50 microg, applied in per oral, vaginal or sub-lingual way. Due to the wide application of Cytotec medicine, it is already high time to legalize it and to standardize the protocols from its application.
Bozhinova
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D000282:Administration, Intravaginal; D000284:Administration, Oral; D020070:Cervical Ripening / Q000187:drug effects*; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D007880:Legislation, Drug; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D009774:Obstetrics / Q000331:legislation & jurisprudence; D010120:Oxytocics / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D011247:Pregnancy
D010120:Oxytocics; D016595:Misoprostol