The role of carbetocin in the prevention and management of postpartum haemorrhage

Meshykhi, L.S.; Nel, Mark; Lucas, D.N.

doi:10.1016/j.ijoa.2016.10.003

Cited by 22 publications

(15 citation statements)

References 56 publications

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“…We have demonstrated that carbetocin was able to block microglial overactivation associated with gestational LPD, not only in vivo but also directly in vitro. Pleiotropic action of carbetocin as a selective OXTR agonist has been observed on several OXT-target organs and cells as for uterine contraction (Meshykhi, Nel, & Lucas, 2016), together with its central action as antidepressant and anxiolytic drug (Broadbear, Kabel, Tracy, & Mak, 2014).…”

Section: Discussionmentioning

confidence: 99%

Oxytocin receptor agonist reduces perinatal brain damage by targeting microglia

Mairesse

Zinni

Pansiot

et al. 2018

Glia

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Prematurity and fetal growth restriction (FGR) are frequent conditions associated with adverse neurocognitive outcomes. We have previously identified early deregulation of genes controlling neuroinflammation as a putative mechanism linking FGR and abnormal trajectory of the developing brain. While the oxytocin system was also found to be impaired following adverse perinatal events, its role in the modulation of neuroinflammation in the developing brain is still unknown. We used a double‐hit rat model of perinatal brain injury induced by gestational low protein diet (LPD) and potentiated by postnatal injections of subliminal doses of interleukin‐1β (IL1β) and a zebrafish model of neuroinflammation. Effects of the treatment with carbetocin, a selective, long lasting, and brain diffusible oxytocin receptor agonist, have been assessed using a combination of histological, molecular, and functional tools in vivo and in vitro. In the double‐hit model, white matter inflammation, deficient myelination, and behavioral deficits have been observed and the oxytocin system was impaired. Early postnatal supplementation with carbetocin alleviated microglial activation at both transcriptional and cellular levels and provided long‐term neuroprotection. The central anti‐inflammatory effects of carbetocin have been shown in vivo in rat pups and in a zebrafish model of early‐life neuroinflammation and reproduced in vitro on stimulated sorted primary microglial cell cultures from rats subjected to LPD. Carbetocin treatment was associated with beneficial effects on myelination, long‐term intrinsic brain connectivity and behavior. Targeting oxytocin signaling in the developing brain may be an effective approach to prevent neuroinflammation – induced brain damage of perinatal origin.

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Section: Discussionmentioning

confidence: 99%

Oxytocin receptor agonist reduces perinatal brain damage by targeting microglia

Mairesse

Zinni

Pansiot

et al. 2018

Glia

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“…Oxytocin is one of the naturally occurring hormones, which can initiate oxytocin receptors and maintain adequate uterine tone resulting in rhythmic uterine contractions and thereby minimise blood loss [58]. Moreover, oxytocin is first-line uterotonics for prevent uterine atony and PPH during delivery [7].…”

Section: Discussionmentioning

confidence: 99%

Traditional Chinese Medicine Yimucao Injection Combined with Western Medicine for Preventing Postpartum Hemorrhage after Cesarean Section: A Systematic Review and Meta-Analysis

Chen

Xie

Tian

et al. 2019

Evidence-Based Complementary and Alternative Medicine

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Objective. Yimucao injection combined with several contraction uterus drugs is in use for preventing postpartum hemorrhage after cesarean section. The present study is a meta-analysis comparing the efficacy and safety of these drugs. Methods. PubMed, Cochrane Library, Embase, the China National Knowledge Infrastructure (CNKI), the Chinese Biomedical Database (CBM), VIP, and Wanfang database were searched until June 2018. We selected RCTs of Yimucao injection combined with western medicine for preventing postpartum hemorrhage and study quality was assessed using the revised Cochrane risk of bias tool. Forty-eight RCTs are comprised of 7,330 participants. Results. The overall response rate of Yimucao injection combined with western medicine as a class (OR=4.19, 95%CI=2.83, 6.20, P<0.00001) was found to be significantly improved than western medicine alone. Yimucao injection combined with western medicine group could significantly reduce blood loss in intraoperative (SMD= -1.15, 95%CI= -1.43, -0.87, P<0.00001), compared with control group. The treatment group could significantly reduce postpartum blood loss within 2 hours (SMD= -1.73, 95%CI= -2.01, -1.46, P<0.00001) and had a significantly lower blood loss within 24 hours (SMD= -1.92, 95%CI= -2.21, -1.63, P<0.00001) than control group. Additionally, in terms of the safety, Yimucao injection group reduced the risk of adverse events in the course of prevention than the western medicine group. Conclusions. This study demonstrated that Yimucao injection combined with western medicine may be more effective for preventing postpartum hemorrhage after cesarean section. However, high-quality and large multicenter randomized clinical trials will be needed to prove the consequence in the further.

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“…Oxytocin being the most popular uterotonic agent, has been routinely administered after both vaginal delivery and cesarean section [ 4 ]. However, it is associated with dose-related side effects, including hypotension, tachycardia, nausea and vomiting [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Carbetocin is a newer uterotonic agent and a long-acting synthetic octapeptide analogue of oxytocin with oxytocin receptor agonist properties. Because carbetocin has a 4–10 fold longer elimination half-life than that of oxytocin, it provides the benefit of longer duration of oxytocic action without additional administration in post-delivery [ 4 ]. Although the difference between carbetocin and oxytocin in terms of hemodynamic changes, postpartum blood loss and incidence of side effects is not statistically significant [ 4 , 9 ], carbetocin is superior to oxytocin in terms of additional dosing and cost-effectiveness [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic effects of carbetocin administered as an intravenous bolus or infusion during cesarean delivery

Kwon

Kim

et al. 2020

Anesth Pain Med

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Background: Postpartum hemorrhage is the leading cause of maternal mortality. Oxytocin being the most popular uterotonic agent, has been routinely administered after both vaginal delivery and cesarean section. Carbetocin is a newer uterotonic agent and provides the benefit of a longer duration of action without additional administration post-delivery.Methods: We recruited 34 women undergoing elective cesarean section under spinal anesthesia. All patient was received spinal anesthesia using 0.5% hyperbaric Marcaine 8–10 mg in conjugation with fentanyl 20 μg in the left lateral decubitus position. Hartmann’s solution 10–15 ml/kg was administered before carbetocin. The operation started as soon as sensory block at level T4–T6 was confirmed. A non-invasive hemodynamic monitoring cuff (Finometer®) was attached to the patient’s finger soon after the induction of spinal anesthesia. Using the Finometer, we recorded the heart rate and mean arterial pressure at every 15 s, starting from 15 s before the administration of carbetocin to 5 min after. After the removal of the placenta, the bolus group was administered intravenous bolus injection of carbetocin 100 μg and the infusion group was administered carbetocin 100 μg diluted in 50 ml normal saline, over 5 min using an infusion pump.Results: The demographic data showed no significant difference between the two groups. Furthermore, there were no significant hemodynamic differences between the two groups.Conclusions: The method of administration of carbetocin does not influence its hemodynamic effects.

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The role of carbetocin in the prevention and management of postpartum haemorrhage

Cited by 22 publications

References 56 publications

Oxytocin receptor agonist reduces perinatal brain damage by targeting microglia

Oxytocin receptor agonist reduces perinatal brain damage by targeting microglia

Traditional Chinese Medicine Yimucao Injection Combined with Western Medicine for Preventing Postpartum Hemorrhage after Cesarean Section: A Systematic Review and Meta-Analysis

Hemodynamic effects of carbetocin administered as an intravenous bolus or infusion during cesarean delivery

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