Utilization of carbetocin for prevention of postpartum hemorrhage after cesarean section: a randomized clinical trial

Borruto, Franco; Treisser, A; Comparetto, Ciro

doi:10.1007/s00404-009-0973-8

Cited by 81 publications

(51 citation statements)

References 14 publications

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“…[6][7][8]16 The reported side effects of carbetocin during CD include hypotension, headache, nausea, vomiting, tremor, shortness of breath, abdominal pain, back pain, and flushing. 6,7,17 Overall, the incidence of these side effects in our study was comparable with previous data. 8 In our study, however, there was a high incidence of hypotension.…”

Section: Discussionsupporting

confidence: 91%

“…Given the lack of data in the literature, it is difficult to compare the incidence of hypotension found in our study with other carbetocin studies. Borruto et al 17 reported a 21.1% incidence of hypotension after administration of carbetocin 100 lg iv during CD, but the authors failed to provide their definition of hypotension. On the other hand, comparing our data with the findings of a similar population that received small doses of oxytocin, 14 the current study revealed 55% of hypotension, whereas the oxytocin study showed a 30% incidence.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, a comparison with their results is not appropriate as their quantification of blood loss began only after carbetocin administration (mean blood loss of only 159 mL). Borruto et al 17 included both elective and emergency CD in their study and showed a mean blood loss of 600 mL, but the methodology they used was visual estimation. Hematocrit variation calculation used in our study may not be as accurate as hemoglobin extraction techniques, but it provides an assessment free of the subjective bias of visual estimation.…”

Section: Discussionmentioning

confidence: 99%

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Carbetocin at elective Cesarean delivery: a randomized controlled trial to determine the effective dose

Cordovani

Balki

Farine

et al. 2012

Can J Anesth/J Can Anesth

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Purpose The primary objective of our study was to determine the minimum intravenous dose of carbetocin required to produce adequate uterine contraction in 95% of women (effective dose [ED] 95 ) undergoing elective Cesarean delivery (CD). Methods Eighty term pregnant women with low risk for postpartum hemorrhage (PPH) undergoing elective CD under spinal anesthesia were randomly allocated to receive carbetocin intravenously in doses of 80 lg, 90 lg, 100 lg, 110 lg, or 120 lg upon delivery. The consultant obstetrician evaluated the efficacy of the patient's uterine tone as satisfactory or unsatisfactory. In case of unsatisfactory uterine tone, additional uterotonics were administered as per routine institutional practice. Side effects were monitored during the study period. The main outcome measure was satisfactory uterine tone at two minutes after carbetocin administration. Results Satisfactory uterine tone was obtained in 70 subjects (87%) within the dose range of 80-120 lg of carbetocin. It was not possible to calculate the ED 95 of carbetocin due to the even distribution of women with satisfactory uterine tone across all dose groups (P = 0.99). Similarly, the side effects were similar across all dose groups. There was a high overall incidence of hypotension (55%) following the administration of carbetocin.Conclusions In women at low risk for PPH undergoing elective CD, carbetocin doses of 80-120 lg are similarly effective. There is a high incidence of hypotension associated with carbetocin in these doses, and further studies with doses lower than 80 lg are warranted to assess the balance of efficacy and side effects. This trial was registered at www.clinicaltrials.gov (NCT01262742). RésuméObjectif L'objectif principal de notre e´tude e´tait de de´terminer la dose intraveineuse minimum de carbe´tocine ne´cessaire pour obtenir une contraction ute´rine approprie´e chez 95 % des femmes (dose efficace [DE] 95 ) subissant une ce´sarienne programme´e. Méthodes Quatre-vingts femmes enceintes a`terme ayant un faible risque d'he´morragie du postpartum subissant une ce´sarienne programme´e sous rachianesthe´sie ont e´teŕ andomise´es pour recevoir des doses intraveineuses de 80 lg, 90 lg, 100 lg, 110 lg ou 120 lg de carbe´tocine au moment de l'accouchement. L'obste´tricien a e´valueĺ 'efficacite´du tonus ute´rin de la patiente comme satisfaisant ou non satisfaisant. En cas de tonus ute´rin non satisfaisant, des me´dicaments ute´rotoniques supple´mentaires ont e´teá dministre´s conforme´ment aux pratiques habituelles de l'e´tablissement. Les effets inde´sirables ont e´te´surveille´s pendant la dure´e de l'e´tude. Le crite`re de jugement principal a éte´un tonus ute´rin satisfaisant deux minutes apre`s l'administration de carbe´tocine.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Carbetocin at elective Cesarean delivery: a randomized controlled trial to determine the effective dose

Cordovani

Balki

Farine

et al. 2012

Can J Anesth/J Can Anesth

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“…В последнее время интерес ученых вызывают иссле-дования, касающиеся применения агониста окситоцина продолжительного действия -карбетоцина (пабал, «FerringGmbH») с целью предупреждения ПРК [6,14,19,22,[26][27][28][29][30][31]. Именно вопросам профилактики тяжелых ПРК при кесаревом сечении и вагинальных родах, а также обобщению существующих в настоящее время клиниче-ских данных, касающихся эффективности, безопасности и переносимости карбетоцина (пабал) по сравнению с обычными утеротониками, посвящена данная статья.…”

Section: ключевые слова: послеродовые кровотечения профилактика лечunclassified

“…При внутривенном введении период полувыве-дения этого препарата составляет около 40 мин [35], пре-вышая аналогичный показатель у окситоцина в 4-10 раз [13,26,27]. После внутримышечного введения препарата пиковая концентрации его в плазме крови отмечается ме-нее чем через 30 мин, биодоступность составляет 80% [35].…”

Section: ключевые слова: послеродовые кровотечения профилактика лечunclassified

International experience with pabal (carbetocin) for the prevention and treatment of postpartum hemorrhage

Shakurova¹,

Ivshin²,

Yatsukhno³

et al. 2016

Ross. vestn. akush.-ginekol.

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. ShakUrOVa, Cand. Med. Sci.; a.a. iVShiN, Cand. Med. Sci.; l.V. yaTSUkhNO; i.e. yakOVleVa; a.i. yakOVleVa; P.V. kOlyBiNa republican Perinatal Center, republic of karelia, Petrozavodsk, russiaThe given review paper briefly considers traditional medicamentous methods for the prevention and treatment of postpartum hemorrhage. Primary emphasis is placed on the use of the longacting oxytocin agonist carbetocin (pabal) to prevent postpar tum hemorrhage, after abdominal delivery in particular. analysis of published works has established that carbetocin combines the safety and tolerability of oxytocin and the stable uterotonic effect of ergometrine. at present, carbetocin (pabal) is primarily indicated for the prevention of uterine hypotonicity and atony during cesarean section. The single intravenous administration of 100 µg of carbetocin (pabal) versus placebo or intravenous oxytocin significantly reduces the need for additional uterotonics to maintain adequate uterine tone and to prevent/treat massive hemorrhage after cesarean section. The administration of this drug is noted to be associated with a lower rate of adverse effects. Carbetocin (pabal) has great economic advantages over ocytocin.The authors declare no conflicts of interest.

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Carbetocin for preventing postpartum haemorrhage

Chong

Melamed

2012

Cochrane Database of Systematic Reviews

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Utilization of carbetocin for prevention of postpartum hemorrhage after cesarean section: a randomized clinical trial

Cited by 81 publications

References 14 publications

Carbetocin at elective Cesarean delivery: a randomized controlled trial to determine the effective dose

Carbetocin at elective Cesarean delivery: a randomized controlled trial to determine the effective dose

International experience with pabal (carbetocin) for the prevention and treatment of postpartum hemorrhage

Carbetocin for preventing postpartum haemorrhage

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