Carbetocin versus a combination of oxytocin and ergometrine in control of postpartum blood loss
Notice bibliographique
Résumé
A combination of oxytocin and ergometrine is effective in preventing postpartum hemorrhage but is frequently associated with side effects such as retained placenta and hypertension. Carbetocin (Duratocin®) is a newly developed uterotonics and it may represent a promising choice as reported in the literature [1]-[4]. The aim of the current retrospective study was to compare the efficacy of carbetocin and a combination of oxytocin and ergometrine in routine clinical settings. Analysis was performed on 118 women who administered either a single 100 μg does of carbetocin (Duratocin®, Ferring Inc., Toronto, Ontario M2J 5C1 1-800-263-4057) or a combination of 5 IU oxytocin (Syntocinon®, Novartis) and 0.2 mg ergometrine (Methergin®, Novartis) after vaginal delivery from January to April 2003. Any patient with a history of clinically significant disease has been excluded. Carbetocin was introduced into the practice for one of the working teams during the period while a combination of ergometrine and oxytocin was used in another team as the usual practice. The two working teams carried out their practices on every other day. In both practices, medications were given immediately after infant delivery. Blood collection by means of aspiration from operative field began directly after drug administration and ceased at the time of vaginal repair. Amount of blood loss was quantified by weighting the aspirated blood and gauzes. Blood loss at delivery was also estimated by recording the drop in hematocrit. The carbetocin group and the combination group demonstrated similar demographic characteristics. Mean blood loss after carbetocin administration was 163 ml less than that after combined administration of oxytocin and ergometrine (Table 1, p = 0.01). Post hoc power analysis found a 76.4% power at the 5% level. The incidence of postpartum hemorrhage (defined as blood loss ≧ 500 ml) was significantly reduced in the carbetocin group (Table 2, p = 0.01). A significantly greater drop in the hematocrit was also observed in women of the combination group (p = 0.03). Changes in other parameters such as hemoglobin level, blood pressure, pulse, uterine tone, fundal position and amount and type of lochia were similar between the two treatment groups. The study suggests that carbetocin administration is associated with significantly less blood loss and hematocrit drop after vaginal delivery. It appears to be associated with statistically significant reduction in the risk of postpartum hemorrhage. It should be considered as a good alternative to conventional uterotonics in prevention of postpartum hemorrhage after vaginal delivery.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».