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The efficacy of three regimes of uterotonic agents for prevention of postpartum blood loss at undergoing cesarean section: a prospective randomized clinical trial
, 1, 1, 1, 1, 2, 1
Affiliations- Department of Obstetrics and Gynecology, Bezmialem Vakif University Faculty of Medicine, İstanbul, Türkiye
- Department of Biostatistics, Bezmialem Vakif University Faculty of Medicine, İstanbul, Türkiye
open access
Abstract
Objectives: To compare the efficacy of three regimes of uterotonic agents on PPH in women undergoing cesarean section in our RCT.
Material and methods: This study was a randomized controlled study (NCT05083910) performed at the Bezmialem Vakif University between July 2021 and January 2022. All women were randomly allocated into three groups: Group I (n = 52) — oxytocin only; Group II (n = 52) — the combination of oxytocin plus intrauterine misoprostol; Group III (n = 52) — carbetocin only. The primary outcome measures were: PPH to evaluate with the change between the concentrations of preoperative and postoperative hemoglobin, hematocrit and intraoperative blood loss.
Results: The blood loss characteristics, including the change in hemoglobin and the change in hematocrit concentration, intraoperative blood loss, intraoperative additional hemostatic uterine sutures and the need for additional uterotonics, were lowest in group III, although all groups were comparable in terms of blood loss parameters. Group III had the highest blood loss ratio, exceeding 1000 mL. For the combination of oxytocin and intrauterine misoprostol, the ARR was 3.8% (95% CI 20.02–12.33), with a RR of 1.18 (95% CI 0.58–2.39) and a NNT of 26 (95% CI 8.1–4.9); for carbetocin, the ARR was 5.8% (95% CI 22.15–10.61), with a RR of 1.27 (95% CI 0.63–2.53) and a NNT of 17 (95% CI 9.41–4.51).
Conclusions: Our results demonstrate that carbetocin shows no superiority in the prevention of PPH in women undergoing cesarean section. Oxytocin still seems to be a highly effective alternative to prevent PPH.
Abstract
Objectives: To compare the efficacy of three regimes of uterotonic agents on PPH in women undergoing cesarean section in our RCT.
Material and methods: This study was a randomized controlled study (NCT05083910) performed at the Bezmialem Vakif University between July 2021 and January 2022. All women were randomly allocated into three groups: Group I (n = 52) — oxytocin only; Group II (n = 52) — the combination of oxytocin plus intrauterine misoprostol; Group III (n = 52) — carbetocin only. The primary outcome measures were: PPH to evaluate with the change between the concentrations of preoperative and postoperative hemoglobin, hematocrit and intraoperative blood loss.
Results: The blood loss characteristics, including the change in hemoglobin and the change in hematocrit concentration, intraoperative blood loss, intraoperative additional hemostatic uterine sutures and the need for additional uterotonics, were lowest in group III, although all groups were comparable in terms of blood loss parameters. Group III had the highest blood loss ratio, exceeding 1000 mL. For the combination of oxytocin and intrauterine misoprostol, the ARR was 3.8% (95% CI 20.02–12.33), with a RR of 1.18 (95% CI 0.58–2.39) and a NNT of 26 (95% CI 8.1–4.9); for carbetocin, the ARR was 5.8% (95% CI 22.15–10.61), with a RR of 1.27 (95% CI 0.63–2.53) and a NNT of 17 (95% CI 9.41–4.51).
Conclusions: Our results demonstrate that carbetocin shows no superiority in the prevention of PPH in women undergoing cesarean section. Oxytocin still seems to be a highly effective alternative to prevent PPH.
Keywords
postpartum hemorrhage; oxytocin; uterotonic agents
About this articleTitle
The efficacy of three regimes of uterotonic agents for prevention of postpartum blood loss at undergoing cesarean section: a prospective randomized clinical trial
Journal
Issue
Article type
Research paper
Pages
741-747
Published online
2023-08-29
Page views
320
Article views/downloads
333
DOI
Pubmed
Bibliographic record
Ginekol Pol 2023;94(9):741-747.
Keywords
postpartum hemorrhage
oxytocin
uterotonic agents
Authors
Çağlar Çetin
Hanife Rana Dural
Pınar Özcan
Fatma Başak Tanoğlu
Mehmet Serdar Kütük
Özge Pasin
Seda Ateş
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