It is becoming more common for hospitals to use Cytotec (misoprostol or prostaglandin E1) to ripen a woman's cervix and induce labor. Cytotec is a small pill that can be taken orally or broken in pieces and inserted vaginally.
There are growing concerns about the safety of this drug when used for labor induction. A November 1999 Committee Opinion of the American College of Obstetricians and Gynecologists (ACOG) warns: "There have been reports of uterine rupture following misoprostol use for cervical ripening in patients with prior uterine surgery. Thus, until reassuring studies are available, misoprostol is not recommended for cervical ripening in patients who have had prior cesarean delivery or major uterine surgery" (1).
Cytotec's only FDA-approved use is treating ulcers. In August 2000, Searle, Cytotec's manufacturer, sent physicians a letter reminding them that Cytotec was not approved for use as a cervical ripening agent and that it was contraindicated for use in pregnancy (14). The letter listed serious adverse effects associated with using Cytotec, including maternal or fetal death, uterine rupture, and severe vaginal bleeding and shock.