Carbetocin versus Oxytocin for the Prevention of Postpartum Haemorrhage

Abstract

Abstract:Postpartum haemorrhage is the leading cause of maternal mortality worldwide. Total 67-80% of cases are caused by uterine atony. Preventive measures include prophylactic drug use to aid uterine contraction after delivery, thus avoiding severe blood loss and reducing maternal morbidity and mortality. Carbetocin is a synthetic analogue of oxytocin with a long half-life which ensure more effective contraction and less adverse effects. It can be administered as a single dose injection either intravenously or intramuscularly rather than as an infusion over several hours as is the case with oxytocin. Carbetocin is currently indicated for prevention of uterine atony after delivery by caesarean section in spinal or epidural anaesthesia. A reduced need for additional uterotonics was observed with carbetocin vs. oxytocin in high-risk women and carbetocin was at least as effective as syntometrine in low-risk women. Carbetocin is effective treatment for the prevention of postpartum haemorrhage not only following caesarean delivery but also after vaginal delivery in high-risk women and those who suffer from hypertensive disorders in pregnancy. Further research is required to assess whether prophylactic carbetocin is superior to conventional uterotonic agents following vaginal delivery in low-risk women.

Efficacy and Safety of Carbetocin in Prevention of Postpartum Hemorrhage

“…Carbetocin in Caesarean Delivery: Carbetocin is presently authorised in 23 countries for the prevention of uterine atony and excessive bleeding at some stage in spinal or epidural caesarean segment. This healing indication is supported via the effects of two published managed scientific research 8,9 . The first observe, performed at Hameda Memorial clinic, Lahore, turned into an attitude, randomized, case-manipulate, pass-sectional, observational, double-ended, examine-controlled look at.…”

“…Additionally, the female in the carbetocin organization had a sizeable weight benefit in her 20 mins. Investigational drug management vs placebo (p < 0> _ 500 mL determined most effective in ladies receiving oxytocin 9 . Effectiveness in Caesarian Delivery: At some point of those activities, 10% of women pronounced experiencing headache, tremor, hypotension, flushing, nausea, stomach ache, itching and nausea of warmth.…”

“…Effectiveness in Caesarian Delivery: At some point of those activities, 10% of women pronounced experiencing headache, tremor, hypotension, flushing, nausea, stomach ache, itching and nausea of warmth. Within the check assessment Carbetocin vs placebo, warm flashes, belly pain, and pruritus have been moe often discovered with carbetocin it turned into also related to hypotension and transient tachycardia 10 . Destructive occasions observed in research of carbetocin as opposed to oxytocin have been comparable in kind and frequency among remedies, and analyzes of those studies were consistent The risks of headache, tremor, dizziness, flushing, shortness of breath, premature ventricular contraction/tachycardia, stomach ache, nausea, vomiting, metal flavor, itching, back pain, heat sensation, chills, and sweating have been similar.…”