Prevention of Postpartum Haemorrhage in Patients with Severe Preeclampsia Using Carbetocin Versus Misoprostol

K, Ibrahim; Saad, Ahmed

doi:10.1016/j.apme.2017.02.008

Cited by 8 publications

(10 citation statements)

References 15 publications

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“…In addition, Attilakos et al [16] researchers found that there were no significant differences in the secondary outcomes, including major PPH and blood transfusions. This is contrary to other results where the need for blood transfusion was found to be higher with misoprostol as compared to carbetocin [23] . Also, Abd El-Wahab et al [21] showed that the need for blood transfusion was different as in carbetocin group there wasn't any patient need blood transfusion versus 3 cases in misoprostol group need for blood transfusion.…”

Section: Discussioncontrasting

confidence: 99%

“…Ibrahim and Saad [23] performed prospective, randomized study and found that the need of extrauterotonic drugs and need for blood transfusion was significantly higher with misoprostol than carbetocin. In the same line, Larciprete et al [24] compared carbetocin and oxytocin in high-risk patients who underwent caesarean section and they noted that carbetocin was associated with lower use of additional uterotonics.…”

Section: Discussionmentioning

confidence: 99%

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Carbetocin versus Rectal Misoprostol to Decrease Blood Loss in Vaginal Delivery in High Risk Patients for Postpartum Hemorrhage

Hetiba¹,

Mahmoud

Oun

2021

International Journal of Medical Arts

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Background: Postpartum hemorrhage is a critical complication after delivery. Methods to decrease or prevent postpartum hemorrhage continue to develop. The medical prophylaxis is frequently used with extension of the utilized drugs. Aim of the work:The current study aims to evaluate the effects of intravenous carbetocin versus rectal misoprostol to decrease blood loss in vaginal delivery in high risk patients for postpartum hemorrhage. Patients and Methods:The study included 94 Patients. They were selected from those attending for normal vaginal delivery and categorized as high risk for postpartum hemorrhage. All were evaluated on clinical basis, laboratory investigations and abdominal ultrasound. Then patients were randomly assigned into two equal groups; group A [Carbetocin group] received 1 ampoule of Carbetocin [100 μg/ml] intravenously as a bolus injection slowly over one minute after neonatal delivery, and group B [Misoprostol group] received three rectal misoprostol tablets [600 μg] after neonatal delivery. Each group was assessed for hemodynamic changes [blood pressure, pulse and respiratory rate], gastrointestinal [GIT] side effects as nausea, vomiting and metallic taste, vasomotor effects as flushing, headache, itching. Results: The amount of blood loss was significantly lower in the carbetocin group than in the misoprostol group [365.53±41.12 ml vs. 404.68±67.27 ml]. Need for uterotonics reported among 17.0% of misoprostol group compared to none [0.0%] in carbetocin group [P=0.003]. On the other side, need for blood transfusion and uterine massage was also increased in misoprostol than carbetocin groups, but the difference was not statistically significant. The complications [drug side effects] revealed that, there was significant increase of fever, nausea & vomiting, diarrhea and abdominal pain in misoprostol than carbetocin group [21.3%, 10.6%, 19.14% and 21.3% vs. 0.0%, 0.0%, 2.12% and 0.0% successively]. Conclusion:Carbetocin is superior to misoprostol for postpartum hemorrhage, regarding efficacy and safety.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Carbetocin versus Rectal Misoprostol to Decrease Blood Loss in Vaginal Delivery in High Risk Patients for Postpartum Hemorrhage

Hetiba¹,

Mahmoud

Oun

2021

International Journal of Medical Arts

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“…The third study (RCT) was performed in Benha, Egypt [ 22 ] by Mohamad Ibrahim and it included 60 severe pre-eclamptic patients in 2 groups (carbetocin [ n = 30] and misoprostol [ n = 30]). Women with severe preeclampsia and singleton baby, gestational age > 28 weeks and vaginal delivery were included in this study.…”

Section: Resultsmentioning

confidence: 99%

“…Need for blood transfusion and manual removal of the placenta were not significantly different between women who received carbetocin and those who received misoprostol, irrespective of whether the women had cesarean section or vaginal delivery (RR 0.57, 95% CI 0.21–1.58, study 21, 422 participants), (RR 0.73, 95% 0.48 to 1.1, studies 20, 22, 245 participants) respectively. There was no maternal death or ICU admission in the three studies [ 20 – 22 ].…”

Section: Resultsmentioning

confidence: 99%

“…With regard to side effects, the rates of heat sensation, metallic taste, fever, and shivering were significantly lower in women who received carbetocin than in those who received misoprostol [ 21 , 22 ], while the rates of headache, abdominal pain, palpitation, nausea, vomiting [ 21 , 22 ], and pruritus [ 21 ] were not significantly different between women who received carbetocin and those who received misoprostol.…”

Section: Resultsmentioning

confidence: 99%

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The effect of carbetocin compared to misoprostol in management of the third stage of labor and prevention of postpartum hemorrhage: a systematic review

Aziz¹,

Iraqi

Abedi

et al. 2018

Syst Rev

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BackgroundPostpartum hemorrhage (PPH) and the amount of blood loss are directly related to management of the third stage of labor. No previous report has compared the effects of carbetocin to those of misoprostol. The aim of this systematic review was to compare the effects of carbetocin to those of misoprostol for management of the third stage of labor and for the prevention of PPH.MethodsWe searched the Cochrane Library (Central), Web of Science, Scopus, Science Direct, Ovid, clinicaltrial.gov, and PubMed databases on December 28, 2017. Data extraction and risk of bias assessment were performed by 2 of the authors independently. Individual and pooled incidences were calculated for the included studies, with 95% confidence intervals (CIs). We used a fixed model for forest plots without heterogeneity and a random effect model for those with heterogeneity.ResultsOur search identified 117 studies; however, 29 studies were duplicate. Of the 88 non-duplicate studies, 5 met the inclusion criteria. Of these five studies, two are currently underway. Hence, three studies were finally included in our meta-analysis. The pooled estimate of the impact of carbetocin on PPH (500–1000 ml) was (OR 0.27, 95% CI 0.14–0.50). Carbetocin significantly reduced the need for additional uterotonics (RR 0.28, 95% CI 0.15 to 0.49). Reduction in the hemoglobin level and blood loss during the third stage of labor was significantly lower in women who received carbetocin than in those who received misoprostol. The length of the third stage of labor was significantly lower in women who received carbetocin than in those who received misoprostol. The incidence of side effects, such as heat sensation, metallic taste, fever, and shivering, were significantly lower in women who received carbetocin than in those who received misoprostol.ConclusionAlthough this review showed that carbetocin is effective for decreasing PPH, blood loss, the length of the third stage of labor, and the need for additional uterotonics, this conclusion should be considered with caution. Because assessment of PPH is a subjective issue and it is uncertain whether outcomes were assessed blindly in respect to treatment. We recommend future research to verify our findings. Also clinicians may like to consider use of carbetocin for women with low risk for PPH.Electronic supplementary materialThe online version of this article (10.1186/s13643-018-0832-4) contains supplementary material, which is available to authorized users.

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Prophylactic effect of rectal and sublingual misoprostol on postpartum hemorrhage in mothers with preeclampsia following cesarean section surgery; a double-blind randomized controlled trial

Afkham¹,

Hashemnejad

Saeieh

et al. 2022

Annals of Medicine &Amp; Surgery

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Prevention of Postpartum Haemorrhage in Patients with Severe Preeclampsia Using Carbetocin Versus Misoprostol

Cited by 8 publications

References 15 publications

Carbetocin versus Rectal Misoprostol to Decrease Blood Loss in Vaginal Delivery in High Risk Patients for Postpartum Hemorrhage

Carbetocin versus Rectal Misoprostol to Decrease Blood Loss in Vaginal Delivery in High Risk Patients for Postpartum Hemorrhage

The effect of carbetocin compared to misoprostol in management of the third stage of labor and prevention of postpartum hemorrhage: a systematic review

Prophylactic effect of rectal and sublingual misoprostol on postpartum hemorrhage in mothers with preeclampsia following cesarean section surgery; a double-blind randomized controlled trial

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