There is not even any logic behind the question. The microcephaly would be present before the labor is induced.

Misoprostol / Cytotec is a drug that causes uterine contractions, and is a low cost and safe way to induce abortions in the first trimester and to prevent postpartum hemorrhage after the placenta delivers at full term births.   There is no connection between Misoprostol and microcephaly.   It appears on the internet that there is someone (is it you?)  who set up a page on ehealth.me attempting to start a rumor that there is a connection, but there is none.  Creating such a lie may be motivated by anti-abortion sentiment, which is rampant all over the US,    To repeat, there is no connection between microcephaly and Misoprostol.

Judy thank you for your reply but you are completely wrong.

Best wishes

Bernard

Please send me the citation with the evidence .

) Exposure to Misoprostol and Hormones During Pregnancy and Risk of Congenital Abnormalities. T.Da Silva Dal Pizzol, M.T.V. Sanseverino, S.S. Mengue. Cad.Saude Publica, Rio de Janeiro . 24 (6) .1447-1453.Jun 2008.

Hi Bernhard,

its a  big difference indeed if the exposure happened in the first trimester (according to the paper to induce abortion which obviously did not work in these cases) or if its solely used to induce labour around term in an otherwise healthy pregnancy with no other risk factors for microcephaly.

Can you be a bit more precise on the question please? Do you mean misoprostol use for IOL  on women carrying babies with a higher risk for microcephaly?

Cheers, Katharina

Hi Katharina.

I act as an expert witness and I have been asked this direct question by a lawyer who I am writing a report for.Obviously microcephaly does not suddenly appear at the time of delivery and is a rare (0.09%) event anyway.I am just trying to get a realistic handle on the incidence of microcephaly in deliveries which involve Misoprostol.Any help would be greatly appreciated.

Best wishes

Bernard

 You still have not clarified what the case is.     Obviously it was not use at full term, so i presume, in the absense of information that she used Miisoprostol to induce abortion, but then changed her mind and decided half way thru the process, to keep the pregnancy after taking Misoprostol to abort the fetus. 

If she attempted an induced abortion wtih misoprostol and it was unsuccessful, then any medical protocol would have included following up the misoprostol with D&C, to remove the pregnant contents of her uterus.   If she changed her mind after taking misoprostol, then the consequences of MAKING THE DECISION to INDUCE ABORTION using a drug taken to kill the fetus and induce abortion, but then stopping half way thru the process would be completely HER DECISION and rest on her shoulders.  This case should be thrown out of court and no ethical judge or lawyer would entertain it.

Defending unethical use of the medical system is unethical.   It seems to me, a decision to defend a woman who uses the medical system unethically, is also unethical.   But not only unethical.   Millions of women who actually want induced abortions and depend on the ability to get one using Misoprostol, which is cheap and does not even need refrigeration, can be hurt by whimsical law suits like this one, which should be thrown out of court before they even start.    Yet, lawsuits like this are what are directing medical practice today.     I praise you for asking this question on ResearchGate and hope that you use this information to drop the case.

I have no idea what you are talking about.This is an attempt to answer a specific medico-legal question.

It appears the article you presented discusses the exposure to Cytotec (misoprostol) during pregnancy. Cytotec is an abortifacient and will induce labor, though its effect on an early term pregnancy is not well documented. This drug is used to induce abortion and long term effects on the fetus are not studied as these fetuses do not live to term. It is unclear how a pregnant woman could be exposed to Cytotec during pregnancy unless she desired termination. There is no evidence to support microcephaly being caused by the use of misoprostol to induce a full term pregnancy as this is physically impossible due to the timing of development.

If you are acting as an expert witness on this case, we need more information to help you to provide expert advice, as there are inconsistencies in what you are asking. Perhaps an OB or CNM should act as expert witness in this case. 

The reference that Bernard Leddy provided is free full text

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2008000600025&lng=en&nrm=iso&tlng=en

It states that previous studies all found no relationship between Misoprostol and defects. In this study 120 women took misoprostol, and no one knows what else they took, but certainly whatever they could because legal abortion (D&C) is not available to them. The women in the study used Misoprostol and whatever else they thought might kill the fetus.   The study reveals its bias when it refers to the women using Misoprostol to bring on a period, when it was used to kill the fetus.   A study of 120 women desperate to kill their fetus does not serves as evidence that Misoprostol is dangerous.  On the contrary, the danger is caused by the lack of access to legal abortion.     Bernard Leddy is dangerous in that he is attempting to start a new myth, like Andrew Wakefield did when he started the myth that measles vaccine causes autism. 

You should retract that assertion as it may be libelous.I am simply trying to get an answer to a medico-legal question