Effectiveness of prophylactic carbetocin versus oxytocin following vaginal delivery for preventing severe postpartum hemorrhage.
carbetocin
oxytocin
prevention
severe postpartum hemorrhage
vaginal delivery
Journal
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
ISSN: 1879-3479
Titre abrégé: Int J Gynaecol Obstet
Pays: United States
ID NLM: 0210174
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
revised:
20
02
2023
received:
09
01
2023
accepted:
22
02
2023
medline:
15
8
2023
pubmed:
25
2
2023
entrez:
24
2
2023
Statut:
ppublish
Résumé
To compare the effectiveness of prophylactic carbetocin with prophylactic oxytocin for preventing severe postpartum hemorrhage (PPH) following vaginal delivery. This before and after cohort study took place between 2020 and 2021 in a university maternity hospital. In 2021, the protocol for PPH prevention immediately after vaginal delivery changed: intravenous oxytocin (5 IU) was replaced by intravenous carbetocin (100 μg). All patients with vaginal births were included, with two groups compared: patients who received prophylactic oxytocin in 2020 and those who received prophylactic carbetocin in 2021. The primary outcome was severe PPH, defined as one or more of the following: estimated blood loss ≥1500 mL, transfusion ≥4 units of red blood cells, Bakri balloon use, embolization, vascular ligation, hysterectomy, and maternal death. Among 4832 women included, 2417 received oxytocin and 2415 received carbetocin. The rate of severe PPH was similar in both groups (0.5% vs. 0.6%, respectively; adjusted odds ratio, 0.8 [95% confidence interval, 0.4-1.8]). The rate of PPH ≥500 mL was lower in the carbetocin group (4% vs. 5.8%; P = 0.004). Although prophylactic carbetocin was associated with a reduction in the rate of PPH ≥500 mL, carbetocin is no different to oxytocin in preventing severe PPH caused by atony after vaginal delivery.
Substances chimiques
carbetocin
88TWF8015Y
Oxytocin
50-56-6
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
889-894Informations de copyright
© 2023 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.
Références
Blondel B, Coulm B, Bonnet C, Goffinet F, Le Ray C, National Coordination Group of the National Perinatal Surveys. Trends in perinatal health in metropolitan France from 1995 to 2016: results from the French National Perinatal Surveys. J Gynecol Obstet Hum Reprod. 2017;46:701-713.
Say L, Chou D, Gemmill A, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2:e323-e333.
World Health Organization. WHO recommendations uterotonics for the prevention of postpartum haemorrhage: Web annex 7: Choice of uterotonic agents. 2018 https://apps.who.int/iris/handle/10665/277283
Sentilhes L, Goffinet F, Vayssière C, Deneux-Tharaux C. Comparison of postpartum haemorrhage guidelines: discrepancies underline our lack of knowledge. BJOG. 2017;124:718-722.
Voon HY, Suharjono HN, Shafie AA, Bujang MA. Carbetocin versus oxytocin for the prevention of postpartum hemorrhage: a meta-analysis of randomized controlled trials in cesarean deliveries. Taiwan J Obstet Gynecol. 2018;57:332-339.
Amornpetchakul P, Lertbunnaphong T, Boriboonhiransarn D, Leetheeragul J, Sirisomboon R, Jiraprasertwong R. Intravenous carbetocin versus intravenous oxytocin for preventing atonic postpartum hemorrhage after normal vaginal delivery in high-risk singleton pregnancies: a triple-blind randomized controlled trial. Arch Gynecol Obstet. 2018;298:319-327.
Widmer M, Piaggio G, Nguyen TMH, et al. Heat-stable carbetocin versus oxytocin to prevent hemorrhage after vaginal birth. N Engl J Med. 2018;23(379):743-752.
Maged AM, Hassan AM, Shehata NA. Carbetocin versus oxytocin for prevention of postpartum hemorrhage after vaginal delivery in high risk women. J Matern Fetal Neonatal Med. 2016;29:532-536.
Nelson H, O'Brien S, Burnard S, et al. Intramuscular oxytocin versus Syntometrine® versus carbetocin for prevention of primary postpartum haemorrhage after vaginal birth: a randomised double-blinded clinical trial of effectiveness, side effects and quality of life. BJOG. 2021;128:1236-1246.
Sichitiu J, Baud D, Desseauve D. Carbetocin for the prevention of post-partum hemorrhage after vaginal birth: a real-world application. J Matern Fetal Neonatal Med. 2022;35:8114-8117.
Boucher M, Nimrod CA, Tawagi GF, Meeker TA, Rennicks White RE, Varin J. Comparison of carbetocin and oxytocin for the prevention of postpartum hemorrhage following vaginal delivery:a double-blind randomized trial. J Obstet Gynaecol Can. 2004;26:481-488.
Sentilhes L, Vayssière C, Deneux-Tharaux C, et al. Postpartum hemorrhage: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF): in collaboration with the French Society of Anesthesiology and Intensive Care (SFAR). Eur J Obstet Gynecol Reprod Biol. 2016;198:12-21.
Deneux-Tharaux C, Bouvier-Colle MH, the EPIMOMS study group. Severe acute maternal morbidity in France: the epimoms population-based study. Am J Obstet Gynecol. 2017;216:S345-S346.