Intra-umbilical vein injection of carbetocin versus oxytocin in the management of retained placenta

Salem, Mostafa Abdo Ahmed; Saraya, Yasser S.; Badr, M. M.; Soliman, Al-Zahraa Mohammad

doi:10.1016/j.srhc.2019.05.002

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…10 Carbetocin has a half-life of 40 minutes, approximately four to ten minutes longer than oxytocin, with an optimal dosage of 100 μg intravenously. 11 The oxytocin receptor (OXTR) in the uterine smooth muscle can specifically bind carbetocin. The rhythmic contractions of the uterus can be induced by this method.…”

Section: Discussionmentioning

confidence: 99%

Carbetosine, a Long-acting Oxytocin Agonist, as a Uterotonic in the Prevention of the Occurrence of Postpartum Bleeding

Izaak

2024

Indones J Obstet Gynecol

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Objective: To evaluate the comparative effect of carbetocin vs. other uterotonic agents in the prevention of the occurrence of postpartum bleeding. Methods: Medical search engines like Pubmed, Google Scholar, and Cochrane are used for literature searches. The year period covered by the literature is 2013–2023. “Carbetocin” or “long-acting oxytocin” and “uterotonic” are the essential words, together with “post-partum hemorrhage” or “post-partum bleeding.” Data analysis was performed using the RevMan 5.4 application. Results: This study involved 12 clinical trials with a total sample of 32,312 people. Based on forest plot analysis, it was found that patients receiving carbetocin therapy had a risk of developing postpartum bleeding of 0.42 times compared to those receiving other uterotonic agents (misoprostol and oxytocin) (OR: 0.42; 95% CI: 0.26-0.68; p<0.0004; with heterogeneity p<0.00001, I2 85%) Conclusion: With its effectiveness and efficacy, carbetocin can be considered one modality that can prevent postpartum hemorrhage. In addition, it can benefit women at risk of having a major obstetric hemorrhage. Keywords: carbetocin, uterotonic, meta-analysis, clinical trial

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Section: Discussionmentioning

confidence: 99%

Carbetosine, a Long-acting Oxytocin Agonist, as a Uterotonic in the Prevention of the Occurrence of Postpartum Bleeding

Izaak

2024

Indones J Obstet Gynecol

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“… 9 More recently, intra-umbilical carbetocin 100mcg in 20ml normal saline was found to be more effective than oxytocin 20IU in 20ml saline for management of retained placenta. 10 One trial found intra-umbilical oxytocin in 50ml saline for routine management of third stage of labour to be more effective than intra-umbilical saline alone, and the effect was dose-related from 10IU to 30IU. 11 To our knowledge no trials have been reported on the use of intra-umbilical oxytocin at caesarean section.…”

Section: Introductionmentioning

confidence: 99%

Preliminary efficacy, feasibility and safety of intra-umbilical oxytocin to reduce the time to placental delivery at caesarean section: an exploratory randomized trial

Middleton,

Mbengo,

Redford Mavundla

et al. 2023

Afr H. Sci.

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Background: Delayed placental separation either after vaginal birth or caesarean birth is an important cause of postpartum haemorrhage, among other causes such as uterine atony. Intra-umbilical oxytocin has been shown to reduce the time to placental delivery after vaginal birth. However, the efficacy of intra-umbilical oxytocin to reduce the time to placental delivery following caesarean section birth is not known. Objectives: To explore the preliminary efficacy, feasibility and safety of intra-umbilical oxytocin to reduce the time to placental delivery at caesarean section. Methods: A double-blind, placebo-controlled, exploratory randomized clinical trial was conducted at a tertiary hospital in the Eastern Cape Province, South Africa. A total of 66 women undergoing elective caesarean section were enrolled in the study and randomized into oxytocin group (n = 33) receiving an intra-umbilical infusion of 20 units of oxytocin in 30ml saline, and placebo group (n = 33) receiving an intra-umbilical infusion of 30ml saline. Data were analysed using Epi Info and RevMan software. Preliminary efficacy was assessed by examining the time elapsed from birth of the baby to complete delivery of the placenta; blood loss more than 500 ml; the need for manual removal of the placenta; and the completeness of the placenta. Feasibility was determined by observing the successful insertion of the catheter and injection of the solution. Safety was evaluated by investigating adverse effects of the procedure. Results: Four women (12%) in the placebo group had a delayed placental delivery compared to one (3%) in the oxytocin group. The mean time from birth to placental delivery was 159 (SD 61) seconds in the placebo group and 143 (SD 45) seconds in the oxytocin group. There was no statistically significant difference between the two groups. Feasibility of the procedure was confirmed by successful insertion of the catheter and injection of the majority of the solution in all 66 cases. No adverse effects of the procedure were identified. Conclusion: Administration of intra-umbilical oxytocin is feasible, safe and has potential to reduce the time of placental delivery at caesarean section. Further studies involving larger sample sizes are justified. Keywords: Caesarean section; intra-umbilical oxytocin; postpartum haemorrhage.

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Umbilical vein injection for management of retained placenta

Kumar

Jahanfar

Haas

et al. 2021

Cochrane Database of Systematic Reviews

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Intra-umbilical vein injection of carbetocin versus oxytocin in the management of retained placenta

Cited by 4 publications

References 13 publications

Carbetosine, a Long-acting Oxytocin Agonist, as a Uterotonic in the Prevention of the Occurrence of Postpartum Bleeding

Carbetosine, a Long-acting Oxytocin Agonist, as a Uterotonic in the Prevention of the Occurrence of Postpartum Bleeding

Preliminary efficacy, feasibility and safety of intra-umbilical oxytocin to reduce the time to placental delivery at caesarean section: an exploratory randomized trial

Umbilical vein injection for management of retained placenta

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