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

Taheripanah, Robabeh; Shoman, A.; Karimzadeh, Mohammad Ali; Zamaniyan, Marzieh; Malih, Narges

doi:10.1080/14767058.2017.1355907

Cited by 22 publications

(25 citation statements)

References 23 publications

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“…1). After exclusions, five RCTs were included in the review, [22][23][24][25][26] with a total of 1,214 patients. Table 1 outlines the study characteristics.…”

Section: Resultsmentioning

confidence: 99%

Carbetocin compared with oxytocin in non-elective Cesarean delivery: a systematic review, meta-analysis, and trial sequential analysis of randomized-controlled trials

Onwochei

Owolabi

Singh

et al. 2020

Can J Anesth/J Can Anesth

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Purpose Carbetocin has been shown to reduce the requirement for additional uterotonics in women exclusively undergoing elective Cesarean delivery (CD). The aim of this review was to determine whether this effect could also be demonstrated in the setting of non-elective CD. Methods Medline, Embase, CINAHL, Web of Science and Cochrane databases were searched for randomizedcontrolled trials (RCTs) in any language comparing carbetocin to oxytocin. Studies with data on women undergoing non-elective CD, where carbetocin was compared with oxytocin, were included. The primary outcome was the need for additional uterotonics. Secondary outcomes included incidence of blood transfusion, estimated blood loss (mL), incidence of postpartum hemorrhage (PPH; [ 1000 mL) and mean hemoglobin drop (gÁdL -1

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“…1). After exclusions, five RCTs were included in the review, [22][23][24][25][26] with a total of 1,214 patients. Table 1 outlines the study characteristics.…”

Section: Resultsmentioning

confidence: 99%

Carbetocin compared with oxytocin in non-elective Cesarean delivery: a systematic review, meta-analysis, and trial sequential analysis of randomized-controlled trials

Onwochei

Owolabi

Singh

et al. 2020

Can J Anesth/J Can Anesth

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“…We used the dosing scheme (and the PPH risk) described by Borruto et al 22 and Attilakos et al 23 because they included women with at least one risk factor for PPH. In other studies, using even higher doses of oxytocin, [26][27][28][29] the risk reduction with carbetocin was even greater; however, there are differences in the characteristics of the population, particularly related to the level of risk that does not allow to clearly observe the differences between alternatives, so it was preferred to adopt a conservative scenario. Regarding utility values, these were based on international studies, since there are no quality of life studies available in our country, and these may not necessarily reflect the preferences of Colombian patients.…”

Section: Discussionmentioning

confidence: 98%

Cost-effectiveness of Carbetocin versus Oxytocin for Prevention of Postpartum Hemorrhage Resulting from Uterine Atony in Women at high-risk for bleeding in Colombia

Gil-Rojas

Lasalvia

Hernández

et al. 2018

Rev Bras Ginecol Obstet

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Objective To assess the cost-effectiveness of carbetocin versus oxytocin for prevention of postpartum hemorrhage (PPH) due to uterine atony after vaginal delivery/ cesarean section in women with risk factors for bleeding. Methods A decision tree was developed for vaginal delivery and another one for cesarean, in which a sequential analysis of the results was obtained with the use of carbetocin and oxytocin for prevention of PPH and related consequences. A third-party payer perspective was used; only direct medical costs were considered. Incremental costs and effectiveness in terms of quality-adjusted life years (QALYs) were evaluated for a one-year time horizon. The costs were expressed in 2016 Colombian pesos (1 USD ¼ 3,051 Col$). Results In the vaginal delivery model, the average cost of care for a patient receiving prophylaxis with uterotonic agents was Col$ 347,750 with carbetocin and Col$ 262,491 with oxytocin, while the QALYs were 0.9980 and 0.9979, respectively. The incremental costeffectiveness ratio is above the cost-effectiveness threshold adopted by Colombia. In the model developed for cesarean section, the average cost of a patient receiving prophylaxis with uterotonics was Col$ 461,750 with carbetocin, and Col$ 481,866 with oxytocin, and the QALYs were 0.9959 and 0.9926, respectively. Carbetocin has lower cost and is more effective, with a saving of Col$ 94,887 per avoided hemorrhagic event. Conclusion In case of elective cesarean delivery, carbetocin is a dominant alternative in the prevention of PPH compared with oxytocin; however, it presents higher costs than oxytocin, with similar effectiveness, in cases of vaginal delivery.

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“…24 According to the results of a randomized clinical study, it was concluded that carbetocin may be a good alternative modality to traditional uterotonic agents such as oxytocin to prevent PPH in patients with cesarean operation under general anesthesia. 25 Meanwhile, although we used 100 μg of carbetocin which was the recommended dose in our study, in a randomized controlled study, patients were given 20, 40, 60, 80 or 100 μg doses and PPH amounts were compared. The results of the study showed that 20-100 μg carbetocin doses were similarly effective in women with low PPH risk undergoing elective cesarean delivery.…”

Section: Discussionmentioning

confidence: 99%

Carbetocin Versus Oxytocin for Prevention of Postpartum Hemorrhage in Cesarean Section

Gürsoy¹,

İlter²,

Çelik³

et al. 2021

J Clin Obstet Gynecol

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This research article was produced from the thesis with the heading of "Comparison of efficiency and side effect profile of carbetocin and oxytocin in patients who underwent caesarean section under general anesthesia". ABS TRACT Objective:We aimed to compare the haemodynamic effects of carbetocin and oxytocin in preventing postpartum hemorrhage during cesarean delivery. Material and Methods: This study was conducted retrospectively in a university hospital. Women in the carbetocin group (n=42) and women in the oxytocin group (n=78) were evaluated in terms of changes in hemoglobin level, hematocrit level, uterotonic need, urine output, blood transfusion requirement, hospital stay, postoperative fever and need for peripartum hysterectomy. Results: There was not statistically significant difference between their additional uterotonic need but preoperative and postoperative 24 th hour hemoglobin reduction, calculated estimated blood loss and platelet count diminution percentage were significantly lower in the carbetocin group compared to oxytocin group (p=0.044; p=0.042; p=0.004, respectively). Besides that, the rate of blood loss of ≥500 mL was lower but not significantly different in patients receiving carbetocin compared to those using oxytocin (p=0.059) and the duration to reach 1,500 cc urine output of carbetocin group was significantly lower than the oxytocin group (p=0.001). Conclusion: Carbetocin appears to be more effective in the hemoglobin reduction, platelet reduction and calculated estimated blood loss. In addition, another advantage of carbetocin is that it has lower negative effects on urine output than oxytocin. It is noteworthy that carbetocin administration can prevent postpartum hemorrhage in appropriate cases.

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

Abstract: 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.

Cited by 22 publications

References 23 publications

Carbetocin compared with oxytocin in non-elective Cesarean delivery: a systematic review, meta-analysis, and trial sequential analysis of randomized-controlled trials

Carbetocin compared with oxytocin in non-elective Cesarean delivery: a systematic review, meta-analysis, and trial sequential analysis of randomized-controlled trials

Cost-effectiveness of Carbetocin versus Oxytocin for Prevention of Postpartum Hemorrhage Resulting from Uterine Atony in Women at high-risk for bleeding in Colombia

Carbetocin Versus Oxytocin for Prevention of Postpartum Hemorrhage in Cesarean Section

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