Carbetocin versus oxytocin for prevention of postpartum hemorrhage after vaginal delivery in high risk women

Maged, Ahmed M.; Hassan, AbdelGany; Shehata, Nesreen A.A.

doi:10.3109/14767058.2015.1011121

Cited by 35 publications

(51 citation statements)

References 17 publications

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“…Average 34 ml more blood loss was observed in oxytocin group. Similar results shown by other two studies that average blood loss was more in oxytocin group than carbetocin group 32,33 . In this study average blood loss in carbetocin group was 325 ml and oxytocin group was 389 ml.…”

Section: Discussionsupporting

confidence: 91%

Efficacy and Safety of Carbetocin in Comparison to Oxytocin in the Active Management of Third Stage of Labour Following Vaginal Delivery: An Open Label Randomized Control Trial

Kabir

Akter

Daisy

et al. 2016

Bangladesh J Obstet Gynaecol

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Objective(S):This study was conducted to evaluate the efficacy and safety of carbetocin in comparison to oxytocin in the active management of third stage of labour following vaginal delivery.Methods:A randomized-controlled trial was conducted in the Institute of Child and Mother Health (ICMH), Dhaka, Bangladesh over a period of nine months from January to September, 2015. Patients who got admitted in ICMH with labour pain were assessed by general examination, abdominal examination and labour status was confirmed by per vaginal examination. On the basis of selection criteria total 94 pregnant women who had undergone vaginal delivery were randomized for two groups of drugs. According to computer generated randomization sequential number was allocated for cases. One group of patients received intravenous 100 micro gram carbetocin and another group of patients received intramuscular 10 IU oxytocin in third stage of labour. Outcome measures such as amount of blood loss in 24 hours, primary PPH, massive blood loss, need of fundal massage, need for additional uterotonic therapy, blood transfusions as well as other adverse effects were all documented.Results: In this study, massive blood loss did not occur in any of patients in carbetocin group. But massive blood loss occurred in 8.5% women of oxytocin group. Further fundal massage, immediate blood transfusion and additional uterotonics were not needed by any patient in carbetocin group. In oxytocin group, fundal massage required in 10.6% of women, blood transfusion was needed for 6.4% patients and additional uterotonics was needed for 10.6% women. Average amount of blood loss were 64 ml less in carbetocin group and adverse effects of drugs were almost similar in both groups. Primary PPH was developed 6.4% in oxytocin group but none of patients developed PPH in carbetocin group.Conclusion: Carbetocin appears to be an effective new drug in the active management of third stage of labour in vaginal delivery. A single dose of 100 microgram IV carbetocin is more effective than oxytocin for maintaining adequate uterine tone, less blood loss and preventing postpartum bleeding in women undergoing vaginal delivery. So, carbetocin can be considered as a good alternative to oxytocin in the active management of third stage of labour in vaginal deliveryBangladesh J Obstet Gynaecol, 2015; Vol. 30(1) : 3-9

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Section: Discussionsupporting

confidence: 91%

Efficacy and Safety of Carbetocin in Comparison to Oxytocin in the Active Management of Third Stage of Labour Following Vaginal Delivery: An Open Label Randomized Control Trial

Kabir

Akter

Daisy

et al. 2016

Bangladesh J Obstet Gynaecol

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“…10 This study is comparable to recent studies in 2016-2017. 11,[21][22][23] Mohamed Maged et al in 2015 conducted a prospective double-blind randomized study to compare the effectiveness of carbetocin with oxytocin for prevention of PPH in high risk patients following vaginal delivery. 200 women were recruited and divided into two groups.…”

Section: Carbetocin Versus Oxytocinmentioning

confidence: 99%

“…Adverse effects such as nausea, vomiting, flushing, dizziness, headache, shivering, metallic taste, dyspnea, palpitation and itching were similar between two groups. 11 Hassan et al in 2017 conducted a comparative prospective case-controlled single centre study to compare the effectiveness of carbetocin with oxytocin for prevention of PPH in high risk patients following cesarean section. 200 women were recruited and divided into two groups.…”

Section: Carbetocin Versus Oxytocinmentioning

confidence: 99%

“…1 Several studies have reported that carbetocin decreases the need for additional uterotonic agents compared to oxytocin. 7,10,11 Moreover, studies from Reyes et al and Nucci et al showed that carbetocin had similar safety profile with oxytocin in preventing PPH in women with severe preeclampsia. 12,13 Therefore, the author is interested to write this review article to compare the efficacy of carbetocin with other uterotonic agents in preventing postpartum hemorrhage using recent evidence.…”

Section: Introductionmentioning

confidence: 98%

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Comparison of carbetocin with other uterotonic agents in preventing postpartum hemorrhage

Carlisa¹

2018

Int J Reprod Contracept Obstet Gynecol

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Postpartum hemorrhage (PPH) is defined as blood loss of at least 500 ml or more after vaginal delivery and 1000 ml or more after abdominal delivery. It contributes up to 28% of maternal mortality worldwide and 30.3% of maternal death in Indonesia. 70% cases of PPH are caused by uterine atony. PPH can be prevented by doing routine use of uterotonic agents in active management of third stage of labour. Uterotonic agents that currently available are oxytocin, carbetocin, methylergometrine, syntometrine, misoprostol and carboprost. Carbetocin (a long-acting synthetic analogue of oxytocin) is a new drug which has stronger ability to induce uterine contraction than oxytocin. It does not induce hypertension like methylergometrine and syntometrine. Therefore, carbetocin can be considered as an alternative drug to oxytocin in women with severe preeclampsia. However, more studies are needed to assess the efficacy and safety of carbetocin for prevention of PPH in preeclamptic women. Compared to methylergometrine and syntometrine, carbetocin is more effective in reducing postpartum blood loss. Adverse effects like nausea and vomiting were lower in women treated with carbetocin. Compared to misoprostol, carbetocin is also superior in reducing blood loss. Adverse effects like shivering, fever and metallic taste were higher in women treated with misoprostol. Further studies are needed to assess the superiority between carbetocin and carboprost since there is no published literature yet regarding this topic. In conclusion, carbetocin is superior to other uterotonic agents in preventing postpartum hemorrhage with fewer adverse effects.

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“…21,22,23 Occurrence of PPH were less in carbetocin group of this study .This result was similar to a previous prospective double-blinded randomized study conducted in Egypt. 25 Primary postpartum hemorrhage (PPH) is the most common form of major obstetric hemorrhage 26 . It is the most common cause of maternal morbidity in developed countries and a major cause of death worldwide 27,28 .…”

mentioning

confidence: 99%

Efficacy and Safety of Carbetocin in Comparison to Oxytocin for the Prevention of Primary PPH during Caesarean Section: An Open Label Randomized Control Trial

Kabir

Ara

Akter

et al. 2018

J. Bangladesh Coll. Phys.

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Background: Postpartum hemorrhage (PPH) is a potentially life-threatening complication of both vaginal and caesarean delivery. The most frequent cause of postpartum hemorrhage is uterine atony, when the uterus fails to contract fully after delivery of the placenta. For the prevention of this uterine atony we need an effective uterotonic drug. Till now oxytocin is used for enhancing uterine contraction after delivery. But oxytocin has some limitations like shorter halflife, less contraction time and more side effects, whereas carbetocin has prolonged duration of action which ensures more contraction time and less adverse effects. So, carbetocin considered as a good alternative over oxytocin for the prevention of primary PPH in caesarean section. The Aim of Study: To see the efficacy and safety of carbetocin over oxytocin for the prevention of primary PPH during caesarean section. Patients and Methods: A randomized-controlled trial was conducted in the Institute of Child and Mother Health (ICMH), Dhaka, Bangladesh over a period of nine months from January to September 2016. Ninety-four patients who had got admitted in ICMH undergoing caesarean section at term were randomized into two groups receiving either 10IU oxytocin or 100μg carbetocin, after the operation. Outcome measures such as primary PPH, massive blood loss, need for additional uterotonic drug, additional blood transfusion as well as adverse effects were all documented. Results: This study had shown that carbetocin is superior in comparison to oxytocin for the prevention of primary PPH following caesarean section. Each patient obtained either a single dose of 100 microgram carbetocin intravenously or 10 IU of oxytocin during caesarean section. Massive blood loss occurred in 6.4%patients, blood transfusion needed in 17% patients and additional uterotonic needed for 25.5% patients in oxytocin group but in carbetocin group no massive blood loss occurred, only 2.1% patient needed immediate blood transfusion and no patient was required additional uterotonics. There were no major adverse effects observed in both the groups. No patients had developed PPH in carbetocin group. But 12.8% patients had developed primary PPH in oxytocin group. Conclusion: Carbetocin appears to be an effective new drug than oxytocin for the prevention of primary postpartum hemorrhage in caesarean section. J Bangladesh Coll Phys Surg 2019; 37(1): 19-24

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Carbetocin versus oxytocin for prevention of postpartum hemorrhage after vaginal delivery in high risk women

Abstract: Carbitocin is a better alternative to traditional oxytocin in prevention of PPH after vaginal delivery with minimal hemodynamic changes and similar side effects.

Cited by 35 publications

References 17 publications

Efficacy and Safety of Carbetocin in Comparison to Oxytocin in the Active Management of Third Stage of Labour Following Vaginal Delivery: An Open Label Randomized Control Trial

Efficacy and Safety of Carbetocin in Comparison to Oxytocin in the Active Management of Third Stage of Labour Following Vaginal Delivery: An Open Label Randomized Control Trial

Comparison of carbetocin with other uterotonic agents in preventing postpartum hemorrhage

Efficacy and Safety of Carbetocin in Comparison to Oxytocin for the Prevention of Primary PPH during Caesarean Section: An Open Label Randomized Control Trial

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