Costs of the use of carbetocin in the prevention of uterine atony following delivery of the infant by Caesarean section - retrospective multicenter study.

OBJECTIVES: The aim of this study was to compare the costs of using carbetocin in the prevention of uterine atony following delivery of the infant by Cesarean section (C-section) under epidural or spinal anesthesia with standard methods of prevention (SMP). MATERIAL AND METHODS: This retrospective multicenter study was based on data from three medical centers. A questionnaire was developed to gather patient records on consumption and costs of resources related to C-section, prevention of uterine atony and postpartum hemorrhage (PPH) treatment. Six subpopulations were considered, depending on patient characteristics. The analysis covered two perspectives: that of the hospital and of the public payer. RESULTS: The subpopulations were homogenous, which was a premise for pooling the data. The use of carbetocin in the prevention of uterine atony following Cesarean section generates savings for hospital in comparison with SMP (oxytocin) in 5 of 6 subpopulations. The biggest savings were observed amongst patients who experienced severe PPH and reached 2.6-6.2 thousand PLN per patient. Costs of services related to C-section borne by the hospitals were higher than the refund received from a public payer. The greatest underestimation reached 12.1 thousand PLN per patient. Nevertheless, loss generated by this underfunding was lower in carbetocin versus oxytocin group. CONCLUSIONS: The use of carbetocin instead of SMP gives hospitals an opportunity to make savings as well as to reduce losses resulting from the underfunding of the services provided by the National Health Fund.

[Fetal Parvowirus B19 infection with hydrops fetalis, a case report]. / Obrzek uogólniony plodu w przebiegu zakazenia Parvowirusem B19, opis przypadku.

Parvovirus B19 (B19V) infection during pregnancy is a cause of nonimmune hydrops. We report a case of hydrops fetalis with severe fetal anemia in the course of B19V infection in the third trimester of pregnancy. Maternal and fetal parvovirus B19 infection was confirmed using quantitative real time PCR detection of viral DNA. The affected fetus was treated with three intrauterine transfusions. The baby was delivered by caesarean section at 36 weeks. Up until 6 months of age no abnormalities in the development of the child were observed.