Carbetocin in prevention of postpartum hemorrhage: Experience in a tertiary medical center of Taiwan.

Abstract

OBJECTIVE:

The aim of this retrospective observational study was to determine the efficacy of carbetocin in reducing blood loss and primary postpartum hemorrhage (PPH) in vaginal and cesarean deliveries in a tertiary hospital in Taiwan.

MATERIALS AND METHODS:

Eligible gravid women (27-41 weeks) with available data were categorized into those treated prophylactically with and without carbetocin. The primary outcome was blood loss and incidence of primary PPH as measured by intrapartum/intraoperative and postpartum (recovery room) blood loss.

RESULTS:

A total of 1069 deliveries were evaluated. Maternal age (∼31 years of age), body mass index (∼27 kg/m2) and parity (∼1.4) were similar among those treated with and without carbetocin for both vaginal and cesarean deliveries. The majority [749/1069 (70.1%)] of deliveries were vaginal; a similar proportion of women undergoing vaginal [221/749 (29.5%)] and cesarean [110/320 (34.4%)] deliveries received prophylactic carbetocin for prevention of PPH. Among vaginal deliveries, there was no significant difference in intrapartum (p = 0.083) or postpartum (p = 0.925) blood loss, or incidence of PPH (p = 0.092) between women with versus without carbetocin prophylaxis. However, there was a significant reduction in the intraoperative and total blood loss among cesarean deliveries with versus without carbetocin prophylaxis (p < 0.001). The incidence of PPH was higher [84/320 (26.3%)] among cesarean than among vaginal deliveries [62/749 (8.3%)], but was significantly lower among cesarean deliveries with [18 (16.36%)] versus without [66 (30.45%); p = 0.003] carbetocin prophylaxis.

CONCLUSION:

In Taiwan, prophylactic use of carbetocin resulted in significantly less blood loss and incidence of PPH in cesarean than in vaginal deliveries.

• Authors: Chih-Yao Chen, Yi-Ning Su, Tzu-Hung Lin, Yi Chang, Huann-Cheng Horng, Peng-Hui Wang, Chang-Ching Yeh, Wen-Hsun Chang, Hsin-Yi Huang
• Journal: Taiwanese journal of obstetrics & gynecology (Taiwan J Obstet Gynecol) Vol. 55 Issue 6 Pg. 804-809 (Dec 2016) ISSN: 1875-6263 [Electronic] China (Republic : 1949- )
• PMID: 28040124 (Publication Type: Journal Article, Observational Study)
• Copyright: Copyright © 2016. Published by Elsevier B.V.

Chemical References

• Oxytocics
• Oxytocin
• carbetocin

Topics

• Administration, Intravenous
• Adult
• Chi-Square Distribution
• Delivery, Obstetric (adverse effects, statistics & numerical data)
• Female
• Gestational Age
• Humans
• Incidence
• Oxytocics (administration & dosage)
• Oxytocin (administration & dosage, analogs & derivatives)
• Postpartum Hemorrhage (prevention & control)
• Pregnancy
• Retrospective Studies
• Taiwan