Dose Of Carbetocin Research Articles

Carbetocin versus Oxytocin in the Prevention of Postpartum Haemorrhage after Caesarean Section

Background: postpartum haemorrhage is one of the major contributors to maternal mortality and morbidity worldwide. There are many pharmacological options for the management of postpartum hemorrhage, oxytocin being the first line choice of treatment.Carbetocin, a long acting oxytocin agonist, appears to be a promising agent for the prevention of PPH. This comparative study was between Carbetocin Versus Oxytocin for the Prevention of Postpartum Haemorrhage in Caesarean Section
 Objective: To determine the safety and effectiveness of carbetocin and oxytocin for the prevention of post-partum haemorrhage in caesarean section.
 Methods: Randomized controlled clinical trial was done in the department of Obstetrics and Gynaecology of Sir Salimullah Medical College Mitford Hospital, Dhaka, between February to July 2015. Study population were 64 pregnant women admitted for delivery and underwent caesarean section, who were randomly selected. Women in the intervention group (group I) received injection carbetocin a bolus of 100 mgm IV; women in the standard treatment group (group II) received 10 IU of oxytocin in IV.Both administered immediately after chiidbirth.This trial was registered in SSMC MH with reference no-SSMC/2014/76.
 Result: Difference of mean age,mean gestational age and indication of C/S were not statistically significant between two groups.Regarding haemodynamic effect,both drugs were almost similar.There was no significant difference in per-operetive blood loss,uterine tone, level of uterine fundus, urine output in urobag and hemoglobin level. Need for additional oxytocics required 0(0.0%) vs 5(16.7%) patients in group I and group II respectively and was found statistically significant.Blood transfusion needed was 0(0.0%) vs 3(10.0%) patients and primary PPH 0(0.0%) vs 3(9.4%),though both were not statistically significant. No significant difference regarding side effects and total expense was found.
 Conclusion: Administration of single bolus dose of carbetocin (100 μgIV) after delivery of the baby in caesarean section immediately reduces the need for additional oxytocics, occurrence of primary PPH and further blood transfusion. Side effects are mild and similar in both the groups.
 Bangladesh J Obstet Gynaecol, 2020; Vol. 35(2): 63-67

Efficacy of oxytocin versus carbetocin in prevention of postpartum hemorrhage after cesarean section under general anesthesia: a prospective randomized clinical trial

Objective: To compare the use of carbetocin and oxytocin in the prevention of postpartum hemorrhage after cesarean section.Methods: The present study was a prospective double-blind randomized controlled clinical trial performed in two university-based hospitals in Tehran, Iran. Two hundred and twenty women with the gestational age of more than 37 weeks, who needed cesarean operation, participated in the study. Patients were assigned to receive either a single 100 μg IV dose of carbetocin or a standard 30-international unit IV infusion of oxytocin during 2 h after delivery of placenta. The primary outcome measures were postpartum hemorrhage requiring additional uterotonic drugs, bleeding volume, and the hemoglobin drops.Results: There were meaningful differences in carbetocin versus oxytocin group regarding the hemoglobin drops (1.01 versus 2.05, p = .01), bleeding volume (430.68 CC versus 552.6 CC, p < .001), uterine massages frequency (3.7 versus 4.26, p < .001), and uterine height at 2, 4, and 24 h (p < .001). Oxytocin side effects were significantly higher in comparison with the carbetocin except pruritus which was observed in 27% of patients in the carbetocin versus no cases in the oxytocin group.Conclusions: It may be concluded that carbetocin is a good alternative modality to conventional uterotonic agents such as oxytocin for the prevention of postpartum hemorrhage after cesarean sections.Registration ID in IRCT: NCT02079558

Comparative study between effect of carbetocin and oxytocin on isoflurane-induced uterine hypotonia in twin pregnancy patients undergoing cesarean section

BackgroundCarbetocin is a long acting structural analog of human oxytocin and is given as single IV bolus following the delivery; it is effective as an oxytocin infusion for several hours because the latter has a very short duration of action which requires a continuous infusion to achieve sustained uterotonic activity.Multiple pregnancy is one of the most common causes of postpartum hemorrhage. This study was done to compare the effect of carbetocin and oxytocin on uterine contraction and though the use of other uterotonic drugs postoperative in multiple pregnancy patients undergoing elective C.S.Patients and methodsSixty patients were enrolled in this study, and they were classified randomly into two groups: group C = received 100 μg carbetocin, group O = received 20 IU oxytocin. We compared between the two groups as regard hemodynamic parameters (heart rate and mean arterial blood pressure), uterine contraction, amount of blood loss and number of patients who needed to reduce isoflurane concentration.ResultsAs regards uterine contraction group O needed methylergometrine postoperative significantly more than group C and as regards blood loss; it was significantly decreased more in group C and though less reduction in blood pressure and less effect on heart rate than group O.ConclusionSingle dose of carbetocin appears to be more effective than oxytocin for several hours on uterine contraction and though preventing postpartum hemorrhage in multiple pregnancy patients undergoing elective caesarian section.

Carbetocin at Elective Cesarean Delivery

Purpose The purpose of this study was to determine the intravenous dose of carbetocin required to produce effective uterine contraction in 90% of females (ED90) undergoing elective Cesarean delivery (CD) under spinal anesthesia.

Carbetocin versus oxytocin for prevention of postpartum hemorrhage in obese nulliparous women undergoing emergency cesarean delivery

Objective: To assess and compare the effectiveness and safety of single IV polus dose of carbetocin, versus IV oxytocin infusion in the prevention of PPH in obese nulliparous women undergoing emergency Cesarean Delivery.Methods: A double-blinded randomized-controlled trial was conducted on 180 pregnant women with BMI >30. Women were randomized to receive either oxytocin or carbetocin during C.S. The primary outcome measure was major primary PPH >1000 ml within 24 h of delivery as per the definition of PPH by the World Health Organization Secondary outcome measures were hemoglobin and hematocrit changes pre- and post-delivery, use of further ecobolics, uterine tone 2 and 12-h postpartum and adverse effects.Results: A significant difference in the amount of estimated blood loss or the incidence of primary postpartum haemorrhage (>1000 ml) in both groups. Haemoglobin levels before and 24-h postpartum was similar. None from the carbetocin group versus 71.5% in oxytocin group needed additional utrotonics (p < 0.01). The uterine contractility was better in the carbetocin group at 2, and 12-h postpartum (p < 0.05).Conclusions: A single 100-µg IV carbetocin is more effective than IV oxytocin infusion for maintaining adequate uterine tone and preventing postpartum bleeding in obese nulliparous women undergoing emergency cesarean delivery, both has similar safety profile and minor hemodynamic effect.

Carbetocin at Elective Cesarean Delivery

Purpose The primary objective of our study was to determine the minimum intravenous dose of carbetocin required to produce adequate uterine contraction in 95% of women (effective dose [ED]95) undergoing elective Cesarean delivery (CD).

Double-blind comparison of carbetocin versus oxytocin in preventing uterine atony post cesarean section

Objectives : The aim of this study was to compare carbetocin, a long-acting oxytocin analog, to oxytocin in the prevention of post-cesarean uterine atony. Material and methods : We enrolled 694 patients going for elective repeat cesarean in a Canadian multicentre double-blind randomized clinical trial. We compared the effect of a single dose of carbetocin (100 mcg.IV) to a standard 8 h IV infusion of oxytocin. The primary outcome was the proportion of patients requiring additional uterotonic drugs. The design used a sequential analysis using the double triangular test. Results : The overall uterotonic intervention rate was 7.4%. The odds of treatment failure was 2.0 times higher in the oxytocin group compared with the carbetocin group (respectively 10.1% vs. 4.7%, P<0.05). Interim safety analysis shows carbetocin to be well tolerated with a safety profile similar to oxytocin. Conclusion : Carbetocin, a new drug to prevent uterine atony, appears to be more effective than a continuous infusion of oxytocin in preventing uterine atony post-Cesarean.