Carbetocin versus Oxytocin for the Prevention of Postpartum Hemorrhage in Cesarean Deliveries: A Retrospective Study of Two Consecutive Periods
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Delorme, Pierre
Paris Sorbonne University, Paris, France
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Kayem, Gilles
Department of Obstetrics and Gynecology, Louis Mourier Hospital, FHU Prema, Paris, France
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Legardeur, Hélène
Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire Vaudois, Université de Lausanne, Lausanne, Switzerland
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Roux-Dessarps, Louise Anne
Department of Obstetrics and Gynecology, Centre Hospitalier Simone-Veil, Eaubonne, France
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Girard, Guillaume
Department of Obstetrics and Gynecology, Louis Mourier Hospital, FHU Prema, Paris, France
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Meunier, Geraldine
Department of Obstetrics and Gynecology, Louis Mourier Hospital, FHU Prema, Paris, France
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Keita, Hawa
Paris University, Paris, France
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Mandelbrot, Laurent
Paris University, Paris, France
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Published in:
- American Journal of Perinatology Reports. - Georg Thieme Verlag KG. - 2020, vol. 10, no. 03, p. e241-e246
English
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.
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Language
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Open access status
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gold
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Identifiers
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Persistent URL
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https://sonar.ch/global/documents/149234
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