title: Carbetocin in prevention of postpartum hemorrhage: Experience in a tertiary medical center of Taiwan.
abstract: OBJECTIVE
  The aim of this retrospective observational study was to determine the efficacy of carbetocin in reducing blood loss and primary postpartum hemorrhage (PPH) in vaginal and cesarean deliveries in a tertiary hospital in Taiwan.
  
  
  METHODS
  Eligible gravid women (27-41 weeks) with available data were categorized into those treated prophylactically with and without carbetocin. The primary outcome was blood loss and incidence of primary PPH as measured by intrapartum/intraoperative and postpartum (recovery room) blood loss.
  
  
  RESULTS
  A total of 1069 deliveries were evaluated. Maternal age (∼31 years of age), body mass index (∼27 kg/m2) and parity (∼1.4) were similar among those treated with and without carbetocin for both vaginal and cesarean deliveries. The majority [749/1069 (70.1%)] of deliveries were vaginal; a similar proportion of women undergoing vaginal [221/749 (29.5%)] and cesarean [110/320 (34.4%)] deliveries received prophylactic carbetocin for prevention of PPH. Among vaginal deliveries, there was no significant difference in intrapartum (p = 0.083) or postpartum (p = 0.925) blood loss, or incidence of PPH (p = 0.092) between women with versus without carbetocin prophylaxis. However, there was a significant reduction in the intraoperative and total blood loss among cesarean deliveries with versus without carbetocin prophylaxis (p < 0.001). The incidence of PPH was higher [84/320 (26.3%)] among cesarean than among vaginal deliveries [62/749 (8.3%)], but was significantly lower among cesarean deliveries with [18 (16.36%)] versus without [66 (30.45%); p = 0.003] carbetocin prophylaxis.
  
  
  CONCLUSIONS
  In Taiwan, prophylactic use of carbetocin resulted in significantly less blood loss and incidence of PPH in cesarean than in vaginal deliveries.
authors.affiliation: Dianthus MFM Center Minquan, Dianthus MFM Group, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chih-Yao
authors.initials: CY
authors.lastname: Chen
authors.affiliation: Dianthus MFM Center Minquan, Dianthus MFM Group, Taipei, Taiwan.
authors.forename: Yi-Ning
authors.initials: YN
authors.lastname: Su
authors.affiliation: Dianthus MFM Center Minquan, Dianthus MFM Group, Taipei, Taiwan.
authors.forename: Tzu-Hung
authors.initials: TH
authors.lastname: Lin
authors.affiliation: Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan; Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Yi
authors.initials: Y
authors.lastname: Chang
authors.affiliation: Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan; Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Huann-Cheng
authors.initials: HC
authors.lastname: Horng
authors.affiliation: Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan; Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan. Electronic address: phwang@vghtpe.gov.tw.
authors.forename: Peng-Hui
authors.initials: PH
authors.lastname: Wang
authors.affiliation: Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan; Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Chang-Ching
authors.initials: CC
authors.lastname: Yeh
authors.affiliation: Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Nursing, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Wen-Hsun
authors.initials: WH
authors.lastname: Chang
authors.affiliation: Biostatics Task Force, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Hsin-Yi
authors.initials: HY
authors.lastname: Huang
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D016009:Chi-Square Distribution; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D010120:Oxytocics / Q000008:administration & dosage*; D010121:Oxytocin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D012189:Retrospective Studies; D013624:Taiwan
chemical_list: D010120:Oxytocics; D010121:Oxytocin; C020731:carbetocin
keywords: blood loss; carbetocin; cesarean section; postpartum hemorrhage; vaginal delivery