Departments of Gynaecology, Bronovo Hospital, The Hague, The Netherlands.
Arch Gynecol Obstet. 2013 Jun;287(6):1111-7. doi: 10.1007/s00404-012-2693-8. Epub 2013 Jan 18.
The aim of the study was to compare the prophylactic effects of carbetocin with those of oxytocin for the prevention of uterine atony in patients undergoing elective caesarean section (CS) in the Netherlands. The primary endpoint was the need for additional uterotonic medication.
Each of the five participating Dutch hospitals treated 50-100 term patients with 100 μg of intravenous carbetocin on prescription. Each centre retrieved charts of 250 patients treated with oxytocin according to the hospital's policy for the prevention of uterine atony (oxytocin bolus 5 IU, bolus 10 IU or bolus 5 IU followed by 10 IU in 2 h).
In the carbetocin group 462 subjects were included and in the oxytocin group 1,122. The proportion of subjects needing additional uterotonic treatment was 3.1 % (95 % CI 1.7-5.1 %) after carbetocin and 7.2 % (5.8-8.9 %) after oxytocin; relative risk 0.41 (0.19-0.85); p = 0.0110. Carbetocin was most effective compared with the oxytocin 5 IU bolus subgroup with less need for additional uterotonic medication (3.1 vs. 9.3 %, p = 0.0067) and blood transfusions (2.2 vs. 3.6 %, p = 0.0357).
Compared with oxytocin, prophylaxis of uterine atony with carbetocin after an elective CS diminished the need for additional uterotonics by more than 50 %.
本研究旨在比较卡贝缩宫素与催产素预防荷兰择期剖宫产患者子宫收缩乏力的效果。主要终点是需要额外使用子宫收缩药物。
荷兰的 5 家参与医院每家为 50-100 名足月患者开具 100μg 静脉注射卡贝缩宫素的处方。每家中心根据医院预防子宫收缩乏力的政策（缩宫素 5IU 推注、5IU 推注后 10IU 持续 2h 输注或 10IU 推注）检索了 250 名接受催产素治疗患者的病历。
卡贝缩宫素组纳入 462 例患者，催产素组纳入 1122 例患者。卡贝缩宫素组需要额外使用子宫收缩药物的患者比例为 3.1%（95%CI，1.7-5.1%），催产素组为 7.2%（5.8-8.9%）；相对风险为 0.41（0.19-0.85）；p=0.0110。与催产素 5IU 推注组相比，卡贝缩宫素的效果最佳，需要额外使用子宫收缩药物的患者比例（3.1% vs. 9.3%，p=0.0067）和输血患者比例（2.2% vs. 3.6%，p=0.0357）均更低。
与催产素相比，择期剖宫产术后使用卡贝缩宫素预防子宫收缩乏力可使额外使用子宫收缩药物的需求减少 50%以上。
