PDF icon PDF herunterladen
Open Access
CC BY-NC-ND 4.0 · AJP Rep 2020; 10(03): e241-e246
DOI: 10.1055/s-0040-1715163
Case Report

Carbetocin versus Oxytocin for the Prevention of Postpartum Hemorrhage in Cesarean Deliveries: A Retrospective Study of Two Consecutive Periods

Pierre Delorme
1   Department of Obstetrics and Gynecology, Trousseau Hospital, FHU Prema, Paris, France
2   Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France
3   Paris Sorbonne University, Paris, France
,
Gilles Kayem
1   Department of Obstetrics and Gynecology, Trousseau Hospital, FHU Prema, Paris, France
2   Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France
3   Paris Sorbonne University, Paris, France
4   Department of Obstetrics and Gynecology, Louis Mourier Hospital, FHU Prema, Paris, France
,
Hélène Legardeur
4   Department of Obstetrics and Gynecology, Louis Mourier Hospital, FHU Prema, Paris, France
6   Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire Vaudois, Université de Lausanne, Lausanne, Switzerland
,
Louise Anne Roux-Dessarps
4   Department of Obstetrics and Gynecology, Louis Mourier Hospital, FHU Prema, Paris, France
5   Department of Obstetrics and Gynecology, Centre Hospitalier Simone-Veil, Eaubonne, France
,
Guillaume Girard
1   Department of Obstetrics and Gynecology, Trousseau Hospital, FHU Prema, Paris, France
4   Department of Obstetrics and Gynecology, Louis Mourier Hospital, FHU Prema, Paris, France
,
Geraldine Meunier
4   Department of Obstetrics and Gynecology, Louis Mourier Hospital, FHU Prema, Paris, France
,
Hawa Keita
7   Department of Obstetric Anesthesia-Intensive Care, Louis Mourier Hospital, Paris, France
8   Department of Pediatric and Obstetric Anesthesia-Intensive Care, Necker Enfants Malades Hospital, APHP, Paris, France
9   Paris University, Paris, France
,
Laurent Mandelbrot
4   Department of Obstetrics and Gynecology, Louis Mourier Hospital, FHU Prema, Paris, France
9   Paris University, Paris, France
› Institutsangaben
› Weitere Informationen
Auch verfügbar aufeRef
  Lizenzen und Reprints
Preview

Abstract

Objective The aim of the study is to investigate whether carbetocin prevents postpartum hemorrhage (PPH) more effectively than oxytocin

Methods This historical retrospective single-center cohort study compares women who underwent cesarean deliveries during two periods. During period A, oxytocin was used as a 10-unit bolus immediately after delivery, with 20 units thereafter infused for 24 hours. During period B, carbetocin in a single 100-µg injection replaced this protocol. The main outcome was PPH, defined as a decline in hemoglobin of more than 2 g/dL after the cesarean. The analysis was performed on the overall population and then stratified by the timing of the cesareans (before or during labor). A logistic regression analysis was performed.

Results This study included 1,796 women, 52% of whom had a cesarean before labor; 15% had a PPH. The crude PPH rate was lower in period B than in period A (13 vs. 17%, respectively, odds ratio 0.75, 95% confidence interval [CI]: 0.58–0.98). The difference was no longer significant in the multivariate analysis (adjusted odds ratio: 0.81, 95% CI 0.61–1.06). Results were similar when stratified by the timing of the cesareans (before or during labor).

Conclusion Carbetocin is not superior to oxytocin in preventing PPH. However, it does provide the advantage of requiring a single injection.

Keywords

oxytocin - carbetocin - postpartum hemorrhage - cesarean delivery


Publikationsverlauf

Eingereicht: 24. Januar 2020

Angenommen: 09. April 2020

Artikel online veröffentlicht:
27. August 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.