[Use of carbetocin in prevention of uterine atony during cesarean section. Comparison with oxytocin].
OBJECTIVE
To compare the efficacy of carbetocin versus oxytocin, during delivery in patients undergoing a caesarian section.


METHODS
A two phase observational study (before/after design) was conducted. Use of carbetocin was considered as a sentinel event. Data for 155 women who received carbetocin during a caesarian section were compared with 155 patients who received oxytocin. The main parameter evaluated was the need for haemostatic surgical techniques (vascular sutures, uterine compression sutures, emergent hysterectomy) during caesarian section.


RESULTS
Both populations were comparable, particularly concerning risk factors of postpartum haemorrhage. In the carbetocin group, there was fewer compression sutures during caesarian section (0.6% versus 4.5%, P=0.06), as well as a significant decrease in postoperative intravenous iron administration (6.5% versus 14.5%, P=0.03). Vascular sutures, frequencies of prostaglandin intravenous injections, and blood transfusions during caesarian section were similar in both populations. There wasn't any emergent hysterectomy during the time of this study.


CONCLUSIONS
Prevention of uterine atony during a caesarian section with carbetocin seems to be as effective as oxytocin. Particularly, decreasing rate of surgical compression sutures with use of carbetocin is not significant, and prospective studies with more patients are necessary to confirm these results.
Service de gynécologie-obstétrique, CHU Carémeau, place du Professeur-Robert-Debré, Nîmes cedex, France. gtriopon@hotmail.com
G
G
Triopon
A
A
Goron
J
J
Agenor
G A
GA
Aya
A-L
AL
Chaillou
J
J
Begler-Fonnier
P-J
PJ
Bousquet
P
P
Mares
D000328:Adult; D002585:Cesarean Section; D015331:Cohort Studies; D003692:Delayed-Action Preparations; D005260:Female; D006489:Hemostatic Techniques; D006801:Humans; D007501:Iron / Q000627:therapeutic use; D010120:Oxytocics / Q000627:therapeutic use*; D010121:Oxytocin / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D006473:Postpartum Hemorrhage / Q000188:drug therapy; D011247:Pregnancy; D016896:Treatment Outcome; D014593:Uterine Inertia / Q000188:drug therapy*
D003692:Delayed-Action Preparations; D010120:Oxytocics; D010121:Oxytocin; C020731:carbetocin; D007501:Iron