title: Systematic use of carbetocin during cesarean delivery of multiple pregnancies: a before-and-after study.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  In our population of multiple pregnancies delivered by cesarean, carbetocin did not appear more effective than oxytocin in preventing severe postpartum hemorrhage.
authors.affiliation: Pôle Femme Mère Nouveau-né, Hôpital Jeanne de Flandre, Université Lille Nord de France, 1 Rue Eugène Avinée, 59037, Lille Cedex, France. julie.demetz@hotmail.fr
authors.forename: Julie
authors.initials: J
authors.lastname: Demetz
authors.forename: Demetz
authors.initials: D
authors.lastname: Julie
authors.forename: Elodie
authors.initials: E
authors.lastname: Clouqueur
authors.forename: Clouqueur
authors.initials: C
authors.lastname: Elodie
authors.forename: Anne
authors.initials: A
authors.lastname: D'Haveloose
authors.forename: D'Haveloose
authors.initials: D
authors.lastname: Anne
authors.forename: Pauline
authors.initials: P
authors.lastname: Staelen
authors.forename: Staelen
authors.initials: S
authors.lastname: Pauline
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Ducloy
authors.forename: Ducloy
authors.initials: D
authors.lastname: Anne-sophie
authors.forename: Damien
authors.initials: D
authors.lastname: Subtil
authors.forename: Subtil
authors.initials: S
authors.lastname: Damien
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D010120:Oxytocics / Q000627:therapeutic use*; D010121:Oxytocin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006473:Postpartum Hemorrhage / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D011247:Pregnancy; D011272:Pregnancy, Multiple; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D010120:Oxytocics; D010121:Oxytocin; C020731:carbetocin