Kalinka Jarosław, Lipińska Małgorzata, Sosnowski Dariusz, Wiliński Wojciech, Skoczylas Michał, Serafin Marcin, Prośniewska Maria, Krajewski Paweł, Laudański Tadeusz
Pracownia Medycznych i Srodowiskowych Zagrozen Ciazy, Klinika Perinatologii, I Katedry Ginekologii i Połoznictwa, Uniwersytetu Medycznego w Lodzi.
Ginekol Pol. 2009 Jul;80(7):512-7.
The aim of this study was to evaluate the efficacy of carbetocin in prevention of PPH in women after cesarean section.
We enrolled 60 patients who had undergone cesarean section in tertiary referential center, Department of Perinatology, Medical University of Lodz, Poland, between January and June 2008. Each patient obtained a single 100 microg dose of carbetocin intravenously during cesarean section, immediately after the delivery of the baby and prior to the delivery of the placenta. We evaluated postoperative blood parameters in 2 and 12 hours after the operation, the proportion of patients requiring additional uterotonic agents and adverse events in the whole population and in the group of women with high risk of PPH.
58.1% of patients underwent emergency and 41.3% elective cesarean section delivery. The risk factor of PPH was identified in 38 women (63.3%). The results of this study indicate that carbetocin produces rapid and long-lasting uterine tone. A small drop in mean hemoglobin and hematocrit levels 2 and 12 hours after the operation was observed. 15% of patients required the use of additional uterotonic agents. In the group of women with high risk of PPH, carbetocin appeared to be effective in 79% of the patients. Only 11.4% of patients had minor adverse events.
Carbetocin appears to be an effective new drug in the prevention of postpartum hemorrhage, not only among women undergoing cesarean section but also in the group of women with PPH risk factors.
本研究旨在评估卡贝缩宫素预防剖宫产术后产妇产后出血（PPH）的疗效。
我们纳入了2008年1月至6月期间在波兰罗兹医科大学围产医学系三级转诊中心接受剖宫产的60例患者。每位患者在剖宫产期间、胎儿娩出后立即且胎盘娩出前静脉注射单次100微克剂量的卡贝缩宫素。我们评估了术后2小时和12小时的血液参数、需要使用额外宫缩剂的患者比例以及总体人群和有产后出血高风险女性群体中的不良事件。
58.1%的患者接受了急诊剖宫产，41.3%接受了择期剖宫产。38名女性（63.3%）被确定有产后出血的风险因素。本研究结果表明，卡贝缩宫素能产生快速且持久的子宫收缩。术后2小时和12小时观察到平均血红蛋白和血细胞比容水平略有下降。15%的患者需要使用额外的宫缩剂。在有产后出血高风险的女性群体中，卡贝缩宫素在79%的患者中似乎有效。只有11.4%的患者有轻微不良事件。
卡贝缩宫素似乎是预防产后出血的一种有效新药，不仅对接受剖宫产的女性有效，对有产后出血风险因素的女性群体也有效。
