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Erschienen in:
01.05.2013 | Maternal-Fetal Medicine
Systematic use of carbetocin during cesarean delivery of multiple pregnancies: a before-and-after study
Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 5/2013
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Purpose
Cesarean deliveries of multiple pregnancies are associated with a high risk of hemorrhage. The aim of this study is to evaluate the efficacy of carbetocin administered systematically during cesarean deliveries of multiple pregnancies.
Methods
Single-center retrospective before-and-after study comparing the use of carbetocin to that of oxytocin during cesareans during two consecutive 6-month periods. A composite variable was predefined as the principal endpoint: any one or more of bleeding ≥1,500 mL, transfusion, hemoglobin reduction of 4 g/dL or more or operative intervention (surgery, embolization).
Results
In an intention-to-treat analysis, the comparison of the two groups (n = 24 before and n = 39 after) showed no difference for the occurrence of the composite variable (16.7 vs. 15.4 %, p = 0.89). Nor did the per-protocol analysis (n = 24 before and n = 27 after) differ for it (16.7 vs. 14.8 %, p = 0.86). Moreover, none of the secondary outcome measures studied—moderate blood loss, prescription of sulprostone, cell-saver use, and intravenous iron infusion—differed significantly between the two periods.
Conclusion
In our population of multiple pregnancies delivered by cesarean, carbetocin did not appear more effective than oxytocin in preventing severe postpartum hemorrhage.