Evidence for carbetocin in obstetric hemorrhage
DOI:
https://doi.org/10.56294/saludcyt2023341Keywords:
PPH prevention, Postpartum hemorrhage, Carbetocin, OxytocinAbstract
Introduction: a common procedure is to administer uterotonic agents regularly for the prophylaxis of postpartum and post-cesarean hemorrhage. The typical uterotonic drug recommended for this use is oxytocin, however, literature indicates better beneficial effects with carbetocin due to its sustained and prolonged uterotonic activity, as well as its safety and good tolerability.
Objective: to outline the data on carbetocin that has been found so far in relation to obstetric hemorrhage.
Methods: For this literature review, keywords related to carbetocin and obstetric hemorrhage were located using health sciences descriptors, and then searched in databases and search engines such as Google Scholar, PubMed, Lilacs, SciELO, Cochrane, and PubMed. Out of a total of 100 bibliographies, 32 articles were considered.
Results: Carbetocin is a thermally stable drug with a half-life approximately 4-10 times longer than oxytocin, with sustained uterotonic activity with the administration of a single dose (100 μg) intravenously or intramuscularly.
Conclusions: Carbetocin is a safe drug for prescription in patients with specific pathologies, as it maintains prolonged uterotonic effect, useful in post-cesarean hemorrhages. Its use is not yet fully promoted due to the high cost it represents at present
References
1. Voon, Hian Yan, et al. Carbetocin versus oxytocin for the prevention of postpartum hemorrhage: A meta-analysis of randomized controlled trials in cesarean deliveries. Taiwanese Journal of Obstetrics and Gynecology. 2018; 57(3):332-339. https://doi.org/10.1016/j.tjog.2018.04.002
2. Elbohoty, Ahmed EH, et al. Randomized controlled trial comparing carbetocin, misoprostol, and oxytocin for the prevention of postpartum hemorrhage following an elective cesarean delivery. International Journal of Gynecology & Obstetrics. 2016; 134(3):324-328. https://doi.org/10.1016/j.ijgo.2016.01.025
3. Widmer, Mariana, et al. Room temperature stable carbetocin for the prevention of postpartum haemorrhage during the third stage of labour in women delivering vaginally: study protocol for a randomized controlled trial. Trials. 2016; 17(1):1-9. https://doi.org/10.1186/s13063-016-1271-y
4. Briones, Jamaica Roanne, et al. Economic evaluation of carbetocin as prophylaxis for postpartum hemorrhage in the Philippines. BMC health services research. 2020; 20(1):1-12. https://doi.org/10.1186/s12913-020-05834-x
5. Chen, Chih-Yao, et al. Carbetocin in prevention of postpartum hemorrhage: experience in a tertiary medical center of Taiwan. Taiwanese Journal of Obstetrics and Gynecology. 2016; 55(6):804-809. https://doi.org/10.1016/j.tjog.2016.07.009
6. Gil-Rojas, Yaneth, et al. Cost-effectiveness of Carbetocin versus Oxytocin for Prevention of Postpartum Hemorrhage Resulting from Uterine Atony in Women at high-risk for bleeding in Colombia. Revista Brasileira de Ginecologia e Obstetrícia. 2018; 40:242-250. https://doi.rog/10.1055/s-0038-1655747
7. MSP. Score Mama y Claves Obstétricas. En G. d. Clínica, Clave Roja (págs. 20- 30). Quito, Ecuador 2017.
8. MSP. Instituto Nacional de Estadísticas y Censos. https://www.salud.gob.ec/wpcontent/uploads/2018/05/CIERRE-PROCESO-MM-2018.pdf
9. Vogel, Joshua P., et al. WHO recommendations on uterotonics for postpartum haemorrhage prevention: ¿what works, and which one? BMJ global health. 2019; 4(2):e001466. http://dx.doi.org/10.1136/bmjgh-2019-001466
10. Tran, Nguyen Toan, et al. Implementing Heat-Stable Carbetocin for Postpartum Haemorrhage Prevention in Low-Resource Settings: A Rapid Scoping Review. International Journal of Environmental Research and Public Health. 2022;19(7):3765. https://doi.org/10.3390/ijerph19073765
11. Matthijsse, Suzette, et al. Cost-effectiveness analysis of carbetocin versus oxytocin for the prevention of postpartum hemorrhage following vaginal birth in the United Kingdom. Journal of Medical Economics. 2022; 25(1):129-137. https://doi.org/10.1080/13696998.2022.2027669
12. Theunissen, Fiona J.; Chinery, Lester; Pujar, Yeshita V. Current research on carbetocin and implications for prevention of postpartum haemorrhage. Reproductive Health. 2018; 15(1):55-59. https://doi.org/10.1186/s12978-018-0529-0
13. You, Joyce HS; Leung, Tak-yeung. Cost-effectiveness analysis of carbetocin for prevention of postpartum hemorrhage in a low-burden high-resource city of China. Plos One. 2022; 17(12):e0279130. https://doi.org/10.1371/journal.pone.0279130
14. Van Der Nelson, Helen, et al. Intramuscular oxytocin versus oxytocin/ergometrine versus carbetocin for prevention of primary postpartum haemorrhage after vaginal birth: study protocol for a randomised controlled trial (the IMox study). Trials. 2019;20:1-10. https://doi.org/10.1186/s13063-018-3109-2
15. Malm M, Madsen I, & Kjellström J. Development and stability of a heat‐stable formulation of carbetocin for the prevention of postpartum haemorrhage for use in low and middle‐income countries. Journal of Peptide Science. 2018;24(6):e3082. https://doi.org/10.1002/psc.3082
16. AI, Wen, et al. Side‐effects of carbetocin to prevent postpartum hemorrhage: A systematic review and meta‐analysis of randomized controlled trials. Pharmacology Research & Perspectives. 2021; 9(2):e00745. https://doi.org/10.1002/prp2.745
17. Mannaerts, D., et al. Adverse effects of carbetocin versus oxytocin in the prevention of postpartum haemorrhage after caesarean section: a randomized controlled trial. Journal of pregnancy. 2018;(2018). https://doi.org/10.1155/2018/1374150
18. Van Der Nelson, Helen A., et al. Carbetocin versus oxytocin for prevention of post-partum haemorrhage at caesarean section in the United Kingdom: an economic impact analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2017;210:286-291. https://doi.org/10.1016/j.ejogrb.2017.01.004
19. Brzozowska, Maria, et al. Comparison of carbetocin and oxytocin effectiveness for prevention of postpartum hemorrhage after caesarean delivery. Ginekologia polska. 2015;86(2). https://doi.org/10.17772/gp/1996
20. Martínez Díaz, Paula, et al. Análisis de la efectividad de la carbetocina comparada con la oxitocina en la prevención de la hemorragia postparto tras cesárea en embarazos gemelares. 2020. https://repositorio.unican.es/xmlui/bitstream/handle/10902/19435/MARTINEZ%20DIAZ%2c%20PAULA.pdf?sequence=1&isAllowed=y
21. Suárez González, Juan Antonio, et al. Uso de carbetocina frente al uso de oxitocina en pacientes intervenidas por cesárea con alto riesgo de atonía uterina. Revista Cubana de Obstetricia y Ginecología. 2017;43(2):1-10.
22. Vásquez Ordóñez, Ligia Irene. Efectividad de la carbetocina en la prevención de la hemorragia posparto. 2015. Tesis Doctoral. Universidad de San Carlos de Guatemala. http://www.repositorio.usac.edu.gt/8899/1/Ligia%20Irene%20V%C3%A1squez%20Ord%C3%B3%C3%B1ez.pdf
23. Ibrahim, Khalid Abd Aziz Mohamad; SAAD, Ahmed Samy. Prevention of postpartum haemorrhage in patients with severe preeclampsia using carbetocin versus misoprostol. Apollo medicine. 2017; 14(2):117-122. https://doi.org/10.1016/j.apme.2017.02.008
24. Abd El Aziz, Mohamed A., et al. The effect of carbetocin compared to misoprostol in management of the third stage of labor and prevention of postpartum hemorrhage: a systematic review. Systematic Reviews. 2018;7:1-8. https://doi.org/10.1186/s13643-018-0832-4
25. Delorme, Pierre, et al. Carbetocin versus oxytocin for the prevention of postpartum hemorrhage in cesarean deliveries: a retrospective study of two consecutive periods. American Journal of Perinatology Reports. 2020;10(03):e241-e246. https://doi.org/10.1055/s-0040-1715163
26. Barrett, Jon; KO, Samuel; Jeffery, William. Cost implications of using carbetocin injection to prevent postpartum hemorrhage in a Canadian urban Hospital. Journal of Obstetrics and Gynaecology Canada. 2022;44(3):272-278. https://doi.org/10.1016/j.jogc.2021.09.022
27. Tse, K. Y.; Florrie, N. Y.; Leung, K. Y. Comparison of carbetocin and oxytocin infusions in reducing the requirement for additional uterotonics or procedures in women at increased risk of postpartum haemorrhage after Caesarean section. Hong Kong Medical Journal. 2020; 26(5):382.
28. Robledo, Francisco Javier Posadas. Uso de la carbetocina para prevenir la hemorragia obstétrica. Ginecologia y Obstetricia de Mexico. 2011; 79(07):419-427.
29. Abundio Samano, Verónica. Efectividad de carbetocina en prevención de hemorragia obstétrica asociada a hipotonia uterina. 2012. https://cdigital.uv.mx/bitstream/handle/123456789/47037/AbundioSamanoVeronica.pdf?sequence=1
30. Abdelhamid, Ahmad N., et al. Comparison of the effect of carbetocin versus oxytocin during cesarean section in women with high risk of postpartum hemorrhage. Menoufia Medical Journal. 2019;32(4):1333.
31. Acevedo Amarillas, Humberto. Comparación de la eficacia de carbetocina vs oxitocina para prevenir hemorragia obstétrica. 2012. https://repositorioinstitucional.uabc.mx/bitstream/20.500.12930/4065/1/MED013734.pdf
32. Gallos, Ioannis, et al. Uterotonic drugs to prevent postpartum haemorrhage: a network meta-analysis. Health Technology Assessment (Winchester, England). 2019(23)9:1. https://doi.org/10.3310/hta23090
33. Seow, Kok-Min, et al. Carbetocin versus oxytocin for prevention of postpartum hemorrhage in infertile women with twin pregnancy undergoing elective cesarean delivery. Taiwanese Journal of Obstetrics and Gynecology. 2017;56(3):273-275. https://doi.org/10.1016/j.tjog.2017.04.001
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Copyright (c) 2023 Edison Andrés Tixe Lluglla, María Carolina Chalan Analuisa, Inés Paulina Panimboza Guamán, Jhon Michael Sanaguano Castillo, Pablo Rodrigo Escobar Castillo, Fernanda Gabriela Dután Ortiz, Paola Elizabeth Serpa Román, Michelle Estefanía Quispe Punina (Author)
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