Carbetocin versus a combination of oxytocin and ergometrine in control of postpartum blood loss

Ngan, Lei; Wong, Keong; Martins, Rolando

doi:10.1016/j.ijgo.2007.02.005

Cited by 10 publications

(11 citation statements)

References 3 publications

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“…Lowest blood loss was recorded with 75-125 µg carbetocin and drug-related serious adverse events were not evident until at least 125 µg was administered. These findings confirm that the intramuscular dose of 100 µg carbetocin, effectively used for prevention of uterine atony following vaginal delivery in all recently published studies [26][27][28] , is the optimal dose with respect to safety and tolerability. Another study evaluated drug transfer to breast milk following intramuscular injection of 70 µg carbetocin in five healthy women (7-14 weeks postpartum) 40 .…”

Section: Pharmacological Studies In Volunteerssupporting

confidence: 85%

“…Costs were estimated using the financial information provided by the Mexican Institute of Social Security and were reported in USD. Univariate and probabilistic sensitivity analyses were performed using probability distribution data from the clinical trial and the Monte Carlo Simulation technique 41 . The mean cost per woman was significantly lower following carbetocin treatment (3525 USD) compared with oxytocin treatment (4054 USD) (p<0.0001).…”

Section: Cost-effectiveness Of Carbetocin Vs Oxytocinmentioning

confidence: 99%

“…However, they remain useful therapeutic options for postpartum haemorrhage treatment when other interventions prove ineffective 21 . Recent interest has focused on the prophylactic use of the oxytocin receptor agonist carbetocin [22][23][24][25][26][27][28][29] . Here we review the most recent clinical data regarding the efficacy of carbetocin in the prevention of postpartum haemorrhage following caesarean section and vaginal delivery, and provide an update on the safety and tolerability in comparison to conventional uterotonic agents.…”

mentioning

confidence: 99%

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Carbetocin versus Oxytocin for the Prevention of Postpartum Haemorrhage

Begum

Shaha²,

Mahbuba³

et al. 2016

Faridpur Med Coll J

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Abstract:Postpartum haemorrhage is the leading cause of maternal mortality worldwide. Total 67-80% of cases are caused by uterine atony. Preventive measures include prophylactic drug use to aid uterine contraction after delivery, thus avoiding severe blood loss and reducing maternal morbidity and mortality. Carbetocin is a synthetic analogue of oxytocin with a long half-life which ensure more effective contraction and less adverse effects. It can be administered as a single dose injection either intravenously or intramuscularly rather than as an infusion over several hours as is the case with oxytocin. Carbetocin is currently indicated for prevention of uterine atony after delivery by caesarean section in spinal or epidural anaesthesia. A reduced need for additional uterotonics was observed with carbetocin vs. oxytocin in high-risk women and carbetocin was at least as effective as syntometrine in low-risk women. Carbetocin is effective treatment for the prevention of postpartum haemorrhage not only following caesarean delivery but also after vaginal delivery in high-risk women and those who suffer from hypertensive disorders in pregnancy. Further research is required to assess whether prophylactic carbetocin is superior to conventional uterotonic agents following vaginal delivery in low-risk women.

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Section: Pharmacological Studies In Volunteerssupporting

confidence: 85%

Section: Cost-effectiveness Of Carbetocin Vs Oxytocinmentioning

confidence: 99%

mentioning

confidence: 99%

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Carbetocin versus Oxytocin for the Prevention of Postpartum Haemorrhage

Begum

Shaha²,

Mahbuba³

et al. 2016

Faridpur Med Coll J

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“…A drug without side effects and a long half-life stimulating a prolonged tocolytic effect might improve uterine clearance. The 4 use of carbetocin, a long acting analogue of oxytocin, has been investigated as a beneficial form of treatment on uterine involution in bovines [9], as well as in humans for the treatment of postpartum haemorrhage [10,11,12]. In adult, non-lactating anoestrous mares carbetocin has been shown to have a half-life of approximately 17 min., which is 2.5-fold longer than that of oxytocin, and not associated with any side effects [7].…”

Section: Introductionmentioning

confidence: 99%

Ex vivo influence of carbetocin on equine myometrial muscles and comparison with oxytocin

et al. 2012

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In order to determine the inter-cyclic effect of oxytocin and carbetocin on equine myometrial tissue, the effect of the drugs was evaluated through pharmacokinetic and pharmaco-dynamic studies. The complete pharmacokinetic profile for oxytocin was unknown and had to be established. To do so, 25 IU of oxytocin were administered intravenously to six cycling mares and blood samples were collected before and 2, 4, 8, 2 and 15 min after administration. The half-life of oxytocin was determined to be 5.89 min, the clearance rate 11.67 l/min, MRT 7.78 min, T max 2 min, and C max 0.51 ng/ml. The effective plasma concentration was estimated to be 0.25 ng/ml. This was similar to the concentration achieved for the organ bath study where the EC 50 was calculated at 0.45 ng/ml. To determine the inter-cyclic effect of oxytocin and carbetocin uterine myometrial samples were collected from slaughtered mares in oestrus, dioestrus and anoestrus. The samples were mounted in organ baths and exposed to four ascending, cumulative doses of oxytocin and carbetocin. Area under the curve and amplitude, E max and EC 50 were studied for each agonist and statistically evaluated. The effect of oxytocin on equine myometrial tissue was higher during dioestrus, and surprisingly anoestrus, than during oestrus, whereas the effect of carbetocin was the same independent of the stage of oestrous cycle. A significant difference was found for oestrous and anoestrous samples when oxytocin was used but not when carbetocin was used.

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“…Use of additional uterotonics was similar, with wide confidence intervals (RR 1.3, 95%CI 0.56-3.13), but the occurrence of side-effects was lower in the carbetocin group (nausea: RR 0.18, 95%CI 0.04-0.78; hypertension up to 60 minutes postpartum: RR 0.11, 95%CI 0.03-0.47). In a smaller observational study (27), fewer women in the carbetocin group had a blood loss of >1000 ml (1 of 55 given carbetocin and 9 of 62 given the combination (RR 0.12, 95%CI 0.15-0.94)).…”

Section: Carbetocin Vs Oxytocin-ergometrine Fixed Dose Combinationmentioning

confidence: 91%

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Augensen¹

2010

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Carbetocin versus a combination of oxytocin and ergometrine in control of postpartum blood loss

Cited by 10 publications

References 3 publications

Carbetocin versus Oxytocin for the Prevention of Postpartum Haemorrhage

Carbetocin versus Oxytocin for the Prevention of Postpartum Haemorrhage

Ex vivo influence of carbetocin on equine myometrial muscles and comparison with oxytocin

Nyttig bidrag for å redusere mødredødelighet

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