Uncontrolled before-after study adding carbetocin in addition to oxytocin decreases blood loss for cesarean section in twin pregnancies

Wen Wei Hsu, Han Ying Chen, Shin Yu Lin, Yi Yun Tai, Jessica Kang, Ming Wei Lin, Chien Nan Lee*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Purpose: To evaluate the effectiveness of adding carbetocin to regular uterotonic agents for prevention of postpartum hemorrhage (PPH) after cesarean section for twin pregnancies. Methods: This is a retrospective uncontrolled before-after study done in a tertiary center in Taiwan, 2010–2017. Women with twin pregnancies that underwent cesarean section were enrolled. The control group (n = 114) received oxytocin infusion and direct uterine injection. In addition to these, the study group (n = 127) received 100ug of intravenous carbetocin. Primary endpoint was the change in hemoglobin. Secondary endpoints included risk of PPH and undiagnosed PPH (Hb dropped more than 2 g/dL), blood loss, the need for additional uterotonic maneuvers, and blood transfusion. Hemodynamic changes were also investigated. Results: After adjusting for confounding factors, the change in Hb (0.35 g/dL, 95% CI: −0.03∼0.74) and incidence of PPH (OR 0.30, 95% CI: 0.03∼3.28) were comparable in both groups. However, women with undiagnosed PPH decreased (OR 0.43, 95% CI:0.22∼0.85). Total blood loss in 24 h after delivery also decreased (−40.33 mL, 95%CI: −80.32∼ −0.34). The use of extra uterotonic medications and the need for blood transfusion did not differ. The systolic blood pressure 4 h after childbirth was higher in the carbetocin group (6.71, 95% CI: 2.27∼11.15). Conclusion: The use of carbetocin in addition to regular uterotonic agents decreased total blood loss and undiagnosed PPH. Also, systolic blood pressure 4 h after childbirth is higher in the carbetocin group. There was no significant difference in hemoglobin change and risk of PPH.

Original languageEnglish
Pages (from-to)1635-1641
Number of pages7
JournalJournal of the Formosan Medical Association
Volume120
Issue number8
DOIs
StatePublished - Aug 2021

Keywords

  • Carbetocin
  • Postpartum hemorrhage
  • Twin pregnancy

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