Comparaison entre carbétocine et oxytocine en cours de césarienne dans la prévention des hémorragies du post-partum

Abstract

ObjectivesThe aim of the study was to compare the effectiveness of Carbetocin versus Oxyotcin during caesarean section for preventing postpartum haemorrhage. MethodsProspective observational study (before/after design). Five hundred and forty patients who received an injection of Oxytocin were compared to 262 patients with single injection of 100 micrograms of Carbetocin. The primary outcome was to compare the differential hematocrit level between pre- and postoperative blood samples. The secondary outcome was to compare differential hemoglobin level and the use of complementary therapies for postpartum haemorrhage. ResultsWe did not find any difference between the Oxytocin and Carbetocin groups on differential hematocrit level. There was no difference between the groups regarding the use of additionnal therapies (Sulproston injections, blood transfusions and surgery methods). The rate of postpartum haemorrhage was similar in the two groups (18.7% vs 21.6%; P=0.33). We found a lower percentage of patients with differential of hemoglobin level between 2g/dL and 4g/dL in the Carbetocin group (6.5% vs 15.6%, P<0.001). The proportion of patients requiring intravenous iron administration was significantly lower in the Carbetocin group (6.8% vs 13.8%, P=0.0036) ConclusionAccording to the primary outcome, there is no difference in effectiveness between carbetocin and oxytocin. Carbetocin seems to reduce the need for postoperative intravenous iron injection.