Comparison of the Efficacy of Carbetocin and Oxytocın to Prevent Postpartum Hemorrhage After Cesarean Delivery

Abstract

Objective: This study aimed to compare the effect of postpartum carbetocin and oxytocin administration on the estimated amount of bleeding, need for additional oxytocin and alteration of hemoglobin levels in patients undergoing elective cesarean section under regional anesthesia.

Material and Methods: This study was performed retrospectively between January 2017 and September 2019 in women who delivered by elective cesarean section under regional anesthesia and were administered carbetocin (study group) or oxytocin (control group). Singleton pregnant women at low risk for postpartum hemorrhage who underwent elective cesarean section under regional anesthesia between 37 and 40 weeks of gestation were included in the study. Patients were compared in terms of the estimated amount of bleeding before and after delivery, the need for additional oxytocin and hemoglobin values.

Results: Perioperative estimated bleeding amounts of carbetocin group and oxytocin group were 600±328 cc and 541±215 cc, respectively (p=0.713). There was no significant difference in hemoglobin decrease and additional uterotonic requirement in both groups (p=0.65, p=0.69, respectively).

Conclusion: It seems appropriate to use oxytocin as the first choice in patients with low risk of bleeding, because of its lower cost and similar efficacy in studies.

Keywords

• Cesarean section
• carbetocin
• oxytocin
• postpartum hemorrhage

SEZARYEN DOĞUM SONRASINDA POSTPARTUM HEMORAJİNİN ÖNLENMESİNDE UYGULANAN KARBETOSİN VE OKSİTOSİNİN ETKİNLİĞİNİN KARŞILAŞTIRILMASI

Abstract

Amaç: Bu çalışmanın amacı rejyonal anestezi altında elektif sezaryen ile doğum yapan hastalarda postpartum karbetosin ile oksitosin uygulamasının tahmini kanama miktarı, ek oksitosin ihtiyacı ve hemoglobin değerleri üzerindeki etkisini karşılaştırmaktır.

Gereç ve Yöntemler: Çalışmamız 2017 Ocak ile 2019 Eylül tarihleri arasında hastanemizde rejyonal anestezi altında elektif sezaryen operasyonu ile doğum yapan ve karbetosin uygulanan hasta grubu (vaka grubu) ile, oksitosin uygulanan (kontrol grubu) kadınlar arasında retrospektif olarak yapıldı. Çalışmaya 37 ile 40 gebelik haftaları arasındaki rejyonal anestezi altında elektif sezaryen doğum gerçekleştirilen, postpartum kanama açısından düşük riskli tekil gebe kadınlar dahil edildi. Hastalar, doğum öncesi ve sonrası tahmini kanama miktarı, ek oksitosin ihtiyacı ve hemoglobin değerleri bakımından karşılaştırıldı.

Bulgular: Karbetosin ve oksitosin gruplarının tahmini perioperatif kanama miktarları sırasıyla 600±328 cc ve 541±215 cc olarak saptandı (p=0.713). Her iki grupta hemoglobin düşüşü ve ek uterotonik ihtiyacı bakımından da anlamlı fark saptanmadı (Sırasıyla; p=0.65, p=0.69).

Sonuç: Kanama riski yüksek olmayan hasta grubunda, daha düşük maliyetli olması ve çalışmalarda benzer etkinlik göstermesi nedeniyle oksitosinin hala ilk seçenek olarak kullanılması uygun gözükmektedir.

Keywords

• karbetosin
• oksitosin
• postpartum kanama
• sezaryen

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