title: Carbetocin versus oxytocin for prevention of postpartum hemorrhage in obese nulliparous women undergoing emergency cesarean delivery.
abstract: OBJECTIVE
  To assess and compare the effectiveness and safety of single IV polus dose of carbetocin, versus IV oxytocin infusion in the prevention of PPH in obese nulliparous women undergoing emergency Cesarean Delivery.
  
  
  METHODS
  A double-blinded randomized-controlled trial was conducted on 180 pregnant women with BMI >30. Women were randomized to receive either oxytocin or carbetocin during C.S. The primary outcome measure was major primary PPH >1000 ml within 24 h of delivery as per the definition of PPH by the World Health Organization Secondary outcome measures were hemoglobin and hematocrit changes pre- and post-delivery, use of further ecobolics, uterine tone 2 and 12-h postpartum and adverse effects.
  
  
  RESULTS
  A significant difference in the amount of estimated blood loss or the incidence of primary postpartum haemorrhage (>1000 ml) in both groups. Haemoglobin levels before and 24-h postpartum was similar. None from the carbetocin group versus 71.5% in oxytocin group needed additional utrotonics (p < 0.01). The uterine contractility was better in the carbetocin group at 2, and 12-h postpartum (p < 0.05).
  
  
  CONCLUSIONS
  A single 100-µg IV carbetocin is more effective than IV oxytocin infusion for maintaining adequate uterine tone and preventing postpartum bleeding in obese nulliparous women undergoing emergency cesarean delivery, both has similar safety profile and minor hemodynamic effect.
authors.affiliation: a Obstetrics and Gynecology Department, Faculty of Medicine , Zagazig University , Zagazig , Egypt and.
authors.forename: Manal M
authors.initials: MM
authors.lastname: El Behery
authors.affiliation: a Obstetrics and Gynecology Department, Faculty of Medicine , Zagazig University , Zagazig , Egypt and.
authors.forename: Gamal Abbas
authors.initials: GA
authors.lastname: El Sayed
authors.affiliation: a Obstetrics and Gynecology Department, Faculty of Medicine , Zagazig University , Zagazig , Egypt and.
authors.forename: Azza A Abd
authors.initials: AA
authors.lastname: El Hameed
authors.affiliation: a Obstetrics and Gynecology Department, Faculty of Medicine , Zagazig University , Zagazig , Egypt and.
authors.forename: Badeea S
authors.initials: BS
authors.lastname: Soliman
authors.affiliation: a Obstetrics and Gynecology Department, Faculty of Medicine , Zagazig University , Zagazig , Egypt and.
authors.forename: Walid A
authors.initials: WA
authors.lastname: Abdelsalam
authors.affiliation: b Obstetrics and Gynecology Department, Faculty of Medicine , Suez Canal University , Ismailia , Egypt.
authors.forename: Abeer
authors.initials: A
authors.lastname: Bahaa
mesh_terms: D000328:Adult; D002585:Cesarean Section; D004311:Double-Blind Method; D004630:Emergencies; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D009765:Obesity / Q000150:complications*; D010120:Oxytocics / Q000627:therapeutic use*; D010121:Oxytocin / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D010298:Parity; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D014590:Uterine Contraction / Q000187:drug effects
chemical_list: D006454:Hemoglobins; D010120:Oxytocics; D010121:Oxytocin; C020731:carbetocin
keywords: Carbitocin; emergency C.S.; obesity; oxytocin; postpartum hemorrhage