title: Carbetocin versus oxytocin to reduce additional uterotonic use at non-elective caesarean section: a double-blind, randomised trial (.).
abstract: OBJECTIVE
  We compared the efficacy of Carbetocin (long-acting oxytocin receptor agonist) versus Oxytocin given at non-elective caesarean section.
  
  
  METHODS
  We performed a double-blind, randomised, single-centre study. Eligible women were ≥37 weeks of gestation undergoing emergency caesarean section. Participants received either carbetocin of 100 μg or oxytocin 5 international units. The primary outcome was the need to administer additional uterotonics, as determined by the clinician. Secondary outcomes included estimated blood loss, haemoglobin drop pre-post operation and the need for a blood transfusion Results: From August 2012 to February 2013, 114 women were enroled. Two were excluded from analysis as they received a general anaesthetic. Fifty-nine patients received 100-μg carbetocin; 53 received 5 international units oxytocin. There was no statistically significant difference in the number of women requiring additional uterotonics between the two groups: Carbetocin group 22% and Oxytocin group 13% (p = 0.323). There were no significant differences in the fall in haemoglobin, estimated blood loss, rates of post-partum haemorrhage or blood transfusions.
  
  
  CONCLUSIONS
  Oxytocin and carbetocin have similar requirements for additional uterotonics, estimated blood loss, haemoglobin drop and blood transfusions. There was a trend towards requiring additional uterotonics in patients receiving Carbetocin which was not statistically significant. This study found no benefits in using carbetocin over oxytocin.
authors.affiliation: a Womens Health Unit, Sunshine Hospital , St Albans , VIC , Australia .
authors.forename: Carole-Anne
authors.initials: CA
authors.lastname: Whigham
authors.affiliation: b Epicentre, Royal Melbourne Hospital , Parkville , VIC , Australia .
authors.forename: Alexandra
authors.initials: A
authors.lastname: Gorelik
authors.affiliation: c Department of Anaesthetics , Frankston Hospital , and.
authors.forename: Terrence E
authors.initials: TE
authors.lastname: Loughnan
authors.affiliation: d Womens Health Unit, Frankston Hospital, Frankston , VIC , Australia.
authors.forename: Amar
authors.initials: A
authors.lastname: Trivedi
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D010120:Oxytocics / Q000008:administration & dosage*; D010121:Oxytocin / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D055815:Young Adult
chemical_list: D010120:Oxytocics; D010121:Oxytocin; C020731:carbetocin
keywords: Caesarean section; carbetocin; oxytocin; post-partum haemorrhage; uterotonics