Carbetocin versus a combination of oxytocin and ergometrine in control of postpartum blood loss
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".