title: Carbetocin in comparison with oxytocin in several dosing regimens for the prevention of uterine atony after elective caesarean section in the Netherlands.
abstract: OBJECTIVE
  The aim of the study was to compare the prophylactic effects of carbetocin with those of oxytocin for the prevention of uterine atony in patients undergoing elective caesarean section (CS) in the Netherlands. The primary endpoint was the need for additional uterotonic medication.
  
  
  METHODS
  Each of the five participating Dutch hospitals treated 50-100 term patients with 100 μg of intravenous carbetocin on prescription. Each centre retrieved charts of 250 patients treated with oxytocin according to the hospital's policy for the prevention of uterine atony (oxytocin bolus 5 IU, bolus 10 IU or bolus 5 IU followed by 10 IU in 2 h).
  
  
  RESULTS
  In the carbetocin group 462 subjects were included and in the oxytocin group 1,122. The proportion of subjects needing additional uterotonic treatment was 3.1 % (95 % CI 1.7-5.1 %) after carbetocin and 7.2 % (5.8-8.9 %) after oxytocin; relative risk 0.41 (0.19-0.85); p = 0.0110. Carbetocin was most effective compared with the oxytocin 5 IU bolus subgroup with less need for additional uterotonic medication (3.1 vs. 9.3 %, p = 0.0067) and blood transfusions (2.2 vs. 3.6 %, p = 0.0357).
  
  
  CONCLUSIONS
  Compared with oxytocin, prophylaxis of uterine atony with carbetocin after an elective CS diminished the need for additional uterotonics by more than 50 %.
authors: Departments of Gynaecology, Bronovo Hospital, The Hague, The Netherlands.
authors: C A G
authors: CA
authors: Holleboom
authors: J
authors: J
authors: van Eyck
authors: S V
authors: SV
authors: Koenen
authors: I A M
authors: IA
authors: Kreuwel
authors: F
authors: F
authors: Bergwerff
authors: E C
authors: EC
authors: Creutzberg
authors: H W
authors: HW
authors: Bruinse
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005865:Gestational Age; D006801:Humans; D007275:Injections, Intravenous; D009426:Netherlands; D010120:Oxytocics / Q000008:administration & dosage*; D010121:Oxytocin / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives*; D011247:Pregnancy; D016896:Treatment Outcome; D014593:Uterine Inertia / Q000209:etiology / Q000517:prevention & control*
chemical_list: D010120:Oxytocics; D010121:Oxytocin; C020731:carbetocin