What every pregnant woman should know about a powerful new drug

By Loren Stein

Although French was two weeks past her due date, she was absolutely clear that she did not want labor to be induced. She also wanted to avoid having her baby delivered by Caesarean section. But her physician worried that waiting any long-er could endanger the baby's health. After several lengthy discussions with her doctor, she was persuaded that it was better to induce labor now than risk an emergency Caesarean section delivery later. When she went into the hospital, both French and her baby were healthy and her vital signs were stable. Although details are sketchy at this time, what is known is that at 7pm French was given a drug called Cytotec to induce labor. Near midnight she was reportedly given a second dose to help her labor progress. But something went wrong, and at 4am French's blood pressure began to drop and the baby's heart rate also plum-meted. French then seized and to everyone's horror -- including her husband J.B.'s, who was at her side -- she suddenly died. CPR failed to revive her. Doctors performed an emergency C-section to save the baby, but the baby was born dead.

French's story is the latest tragedy among dozens of cases throughout the nation that are calling attention to the wide-spread use of Cytotec, also known as misoprostol. The drug, devel-oped for the treatment of ulcers, is being widely used in labor and delivery rooms in Santa Clara County, the Bay Area, and across the country. Although Cytotec has never been approved by the FDA for use in obstetrics, obstetrician-gynecologists passionately defend the drug as an irreplaceable tool for labor induction, and say it is safe when strict protocols are followed. But critics contend that the medical community has come to rely on Cytotec to shorten delivery times and save money, and is ignoring a slew of well-respected studies as well as warnings from the manufacturer about its risks. Moreover, they charge that the drug has left a trail of catastrophes in its wake.

"The unapproved use of Cytotec is a scandal," says Dr. Marsden Wagner, a Washington, D.C., neonatalogist and scientist who served for 15 years as a dir-ector of women's and children's health in industrialized coun-tries for the World Health Organ-ization. "It's a tragedy that it hasn't been stopped."

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