Uncontrolled before-after study adding carbetocin in addition to oxytocin decreases blood loss for cesarean section in twin pregnancies.
J Formos Med Assoc
; 120(8): 1635-1641, 2021 Aug.
Article
em En
| MEDLINE
| ID: mdl-33581963
ABSTRACT
PURPOSE:
To evaluate the effectiveness of adding carbetocin to regular uterotonic agents for prevention of postpartum hemorrhage (PPH) after cesarean section for twin pregnancies.METHODS:
This is a retrospective uncontrolled before-after study done in a tertiary center in Taiwan, 2010-2017. Women with twin pregnancies that underwent cesarean section were enrolled. The control group (n = 114) received oxytocin infusion and direct uterine injection. In addition to these, the study group (n = 127) received 100ug of intravenous carbetocin. Primary endpoint was the change in hemoglobin. Secondary endpoints included risk of PPH and undiagnosed PPH (Hb dropped more than 2 g/dL), blood loss, the need for additional uterotonic maneuvers, and blood transfusion. Hemodynamic changes were also investigated.RESULTS:
After adjusting for confounding factors, the change in Hb (0.35 g/dL, 95% CI -0.03â¼0.74) and incidence of PPH (OR 0.30, 95% CI 0.03â¼3.28) were comparable in both groups. However, women with undiagnosed PPH decreased (OR 0.43, 95% CI0.22â¼0.85). Total blood loss in 24 h after delivery also decreased (-40.33 mL, 95%CI -80.32â¼ -0.34). The use of extra uterotonic medications and the need for blood transfusion did not differ. The systolic blood pressure 4 h after childbirth was higher in the carbetocin group (6.71, 95% CI 2.27â¼11.15).CONCLUSION:
The use of carbetocin in addition to regular uterotonic agents decreased total blood loss and undiagnosed PPH. Also, systolic blood pressure 4 h after childbirth is higher in the carbetocin group. There was no significant difference in hemoglobin change and risk of PPH.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Ocitócicos
/
Ocitocina
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Female
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Humans
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Pregnancy
País/Região como assunto:
Asia
Idioma:
En
Revista:
J Formos Med Assoc
Assunto da revista:
MEDICINA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Taiwan