Intramuscular oxytocin versus Syntometrine
Adult
Blood Transfusion
/ statistics & numerical data
Delivery, Obstetric
Double-Blind Method
Ergonovine
/ therapeutic use
Female
Humans
Hypertension
/ epidemiology
Injections, Intramuscular
Oxytocics
/ therapeutic use
Oxytocin
/ analogs & derivatives
Postpartum Hemorrhage
/ prevention & control
Pregnancy
Puerperal Disorders
/ epidemiology
Quality of Life
Postpartum haemorrhage
prevention
uterotonic
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
accepted:
03
12
2020
pubmed:
11
12
2020
medline:
22
6
2021
entrez:
10
12
2020
Statut:
ppublish
Résumé
To compare intramuscular oxytocin, Syntometrine Randomised double-blinded clinical trial. Six hospitals in England. A total of 5929 normotensive women having a singleton vaginal birth. Randomisation when birth was imminent. Primary: use of additional uterotonic agents. Secondary: weighed blood loss, transfusion, manual removal of placenta, adverse effects, quality of life. Participants receiving additional uterotonics: 368 (19.5%) oxytocin, 298 (15.6%) Syntometrine and 364 (19.1%) carbetocin. When pairwise comparisons were made: women receiving carbetocin were significantly more likely to receive additional uterotonics than those receiving Syntometrine (odds ratio [OR] 1.28, 95% CI 1.08-1.51, P = 0.004); the difference between carbetocin and oxytocin was non-significant (P = 0.78); Participants receiving Syntometrine were significantly less likely to receive additional uterotonics than those receiving oxytocin (OR 0.75, 95% CI 0.65-0.91, P = 0.002). Non-inferiority between carbetocin and Syntometrine was not shown. Use of Syntometrine reduced non-drug PPH treatments compared with oxytocin (OR 0.64, 95% CI 0.42-0.97) but not carbetocin (P = 0.64). Rates of PPH and blood transfusion were not different. Syntometrine was associated with an increase in maternal adverse effects and reduced ability of the mother to bond with her baby. Non-inferiority of carbetocin to Syntometrine was not shown. Carbetocin is not significantly different to oxytocin for use of additional uterotonics. Use of Syntometrine reduced use of additional uterotonics and need for non-drug PPH treatments compared with oxytocin. Increased maternal adverse effects are a disadvantage of Syntometrine. IM carbetocin does not reduce additional uterotonic use compared with IM Syntometrine or oxytocin.
Identifiants
pubmed: 33300296
doi: 10.1111/1471-0528.16622
doi:
Substances chimiques
Oxytocics
0
syntometrine
37209-62-4
Oxytocin
50-56-6
carbetocin
88TWF8015Y
Ergonovine
WH41D8433D
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
1236-1246Subventions
Organisme : Ferring
Organisme : North Bristol NHS Trust
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
Références
Prevention and Management of Post Partum Haemorrhage. Green-top Guideline No. 52. London, UK: Royal College of Obstetricians and Gynaecologists; 2009.
Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health 2014;2:e323-33.
Oyelese Y, Ananth CV. Postpartum hemorrhage: epidemiology, risk factors, and causes. Clin Obstet Gynecol 2010;53:147-56.
Vogel JP, Williams M, Gallos I, Althabe F, Oladapo OT. WHO recommendations on uterotonics for postpartum haemorrhage prevention: what works, and which one? BMJ Glob Health 2019;4:e001466.
Al Wattar BH, Tamblyn JA, Parry-Smith W, Prior M, Van Der Nelson H. Management of obstetric postpartum hemorrhage: a national service evaluation of current practice in the UK. Risk Manag Healthc Policy 2017;10:1-6.
Cantwell R, Clutton-Brock T, Cooper G, Dawson A, Drife J, Garrod D, et al. Saving Mothers' Lives: reviewing maternal deaths to make motherhood safer: 2006-2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. BJOG 2011;118 (Suppl 1):1-203.
Widmer M, Piaggio G, Nguyen TMH, Osoti A, Owa OO, Misra S, et al. Heat-stable carbetocin versus oxytocin to prevent hemorrhage after vaginal birth. N Engl J Med 2018;379:743-52.
Adnan N, Conlan-Trant R, McCormick C, Boland F, Murphy DJ. Intramuscular versus intravenous oxytocin to prevent postpartum haemorrhage at vaginal delivery: randomised controlled trial. BMJ 2018;362:k3546.
Gallos ID, Williams HM, Price MJ, Merriel A, Gee H, Lissauer D, et al. Uterotonic agents for preventing postpartum haemorrhage: a network meta-analysis. Cochrane Database Syst Rev 2018;4:CD011689.
van der Nelson H, O'Brien S, Lenguerrand E, Marques E, Alvarez M, Mayer M, et al. Intramuscular oxytocin versus oxytocin/ergometrine versus carbetocin for prevention of primary postpartum haemorrhage after vaginal birth: study protocol for a randomised controlled trial (the IMox study). Trials 2019;20:4.
Meher S. How should we diagnose and assess the severity of PPH in clinical trials? Best Pract Res Clin Obstet Gynaecol 2019;61:41-54.
Askar AA, Ismail MT, El-Ezz AA, Rabie NH. Carbetocin versus syntometrine in the management of third stage of labor following vaginal delivery. Arch Gynecol Obstet 2011;284:1359-65.
Leung SW, Ng PS, Wong WY, Cheung TH. A randomised trial of carbetocin versus syntometrine in the management of the third stage of labour. BJOG 2006;113:1459-64.
Nirmala K, Zainuddin AA, Ghani NA, Zulkifli S, Jamil MA. Carbetocin versus syntometrine in prevention of post-partum hemorrhage following vaginal delivery. J Obstet Gynaecol Res 2009;35:48-54.
Su LL, Rauff M, Chan YH, Mohamad Suphan N, Lau TP, Biswas A, et al. Carbetocin versus syntometrine for the third stage of labour following vaginal delivery - a double-blind randomised controlled trial. BJOG 2009;116:1461-6.
McDonald SJ, Prendiville WJ, Blair E. Randomised controlled trial of oxytocin alone versus oxytocin and ergometrine in active management of third stage of labour. BMJ 1993;307:1167-71.
Yuen PM, Chan NS, Yim SF, Chang AM. A randomised double blind comparison of Syntometrine and Syntocinon in the management of the third stage of labour. Br J Obstet Gynaecol 1995;102:377-80.
van Hout B, Janssen MF, Feng YS, Kohlmann T, Busschbach J, Golicki D, et al. Interim scoring for the EQ-5D-5L: mapping the EQ-5D-5L to EQ-5D-3L value sets. Value Health 2012;15:708-15.
Reduced Fetal Movements. Green-top Guideline No. 57. London, UK: Royal College of Obstetricians and Gynaecologists; 2011.
Service NH. NHS Maternity Statistics, England 2017-2018. https://digital.nhs.uk/data-and-information/publications/statistical/nhs-maternity-statistics/2017-18.
McDonald SJ, Middleton P, Dowswell T, Morris PS. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database Syst Rev 2013;2013:CD004074.
Khireddine I, Le Ray C, Dupont C, Rudigoz RC, Bouvier-Colle MH, Deneux-Tharaux C. Induction of labor and risk of postpartum hemorrhage in low risk parturients. PLoS One 2013;8:e54858.
Briley A, Seed PT, Tydeman G, Ballard H, Waterstone M, Sandall J, et al. Reporting errors, incidence and risk factors for postpartum haemorrhage and progression to severe PPH: a prospective observational study. BJOG 2014;121:876-88.
Hawker L, Weeks A. Postpartum haemorrhage (PPH) rates in randomized trials of PPH prophylactic interventions and the effect of underlying participant PPH risk: a meta-analysis. BMC Pregnancy and Childbirth 2020;20:107.
Diaz V, Abalos E, Carroli G. Methods for blood loss estimation after vaginal birth. Cochrane Database Syst Rev 2018;9:CD010980.
Bell SF, Watkins A, John M, Macgillivray E, Kitchen TL, James D, et al. Incidence of postpartum haemorrhage defined by quantitative blood loss measurement: a national cohort. BMC Pregnancy Childbirth 2020;20:271.
Wei Q, Xu Y, Zhang L. Towards a universal definition of postpartum hemorrhage: retrospective analysis of Chinese women after vaginal delivery or cesarean section: a case-control study. Medicine (Baltimore) 2020;99:e21714.
Attilakos G, Psaroudakis D, Ash J, Buchanan R, Winter C, Donald F, et al. Carbetocin versus oxytocin for the prevention of postpartum haemorrhage following caesarean section: the results of a double-blind randomised trial. BJOG 2010;117:929-36.
Gallos ID, Papadopoulou A, Man R, Athanasopoulos N, Tobias A, Price MJ, et al. Uterotonic agents for preventing postpartum haemorrhage: a network meta-analysis. Cochrane Database Syst Rev 2018;12:CD011689.
Hunter DJ, Schulz P, Wassenaar W. Effect of carbetocin, a long-acting oxytocin analog on the postpartum uterus. Clin Pharmacol Ther 1992;52:60-7.
Heesen M, Carvalho B, Carvalho JCA, Duvekot JJ, Dyer RA, Lucas DN, et al. International consensus statement on the use of uterotonic agents during caesarean section. Anaesthesia 2019;74:1305-19.
Torloni MR, Gomes Freitas C, Kartoglu UH, Metin Gülmezoglu A, Widmer M. Quality of oxytocin available in low- and middle-income countries: a systematic review of the literature. BJOG 2016;123:2076-86.