Whigham Carole-Anne, Gorelik Alexandra, Loughnan Terrence E, Trivedi Amar
a Womens Health Unit, Sunshine Hospital , St Albans , VIC , Australia .
b Epicentre, Royal Melbourne Hospital , Parkville , VIC , Australia .
J Matern Fetal Neonatal Med. 2016 Dec;29(23):3866-9. doi: 10.3109/14767058.2016.1149564. Epub 2016 Mar 3.
We compared the efficacy of Carbetocin (long-acting oxytocin receptor agonist) versus Oxytocin given at non-elective caesarean section.
We performed a double-blind, randomised, single-centre study. Eligible women were ≥37 weeks of gestation undergoing emergency caesarean section. Participants received either carbetocin of 100 μg or oxytocin 5 international units. The primary outcome was the need to administer additional uterotonics, as determined by the clinician. Secondary outcomes included estimated blood loss, haemoglobin drop pre-post operation and the need for a blood transfusion Results: From August 2012 to February 2013, 114 women were enroled. Two were excluded from analysis as they received a general anaesthetic. Fifty-nine patients received 100-μg carbetocin; 53 received 5 international units oxytocin. There was no statistically significant difference in the number of women requiring additional uterotonics between the two groups: Carbetocin group 22% and Oxytocin group 13% (p = 0.323). There were no significant differences in the fall in haemoglobin, estimated blood loss, rates of post-partum haemorrhage or blood transfusions.
Oxytocin and carbetocin have similar requirements for additional uterotonics, estimated blood loss, haemoglobin drop and blood transfusions. There was a trend towards requiring additional uterotonics in patients receiving Carbetocin which was not statistically significant. This study found no benefits in using carbetocin over oxytocin.
我们比较了卡贝缩宫素(长效催产素受体激动剂)与催产素在非选择性剖宫产中的疗效。
我们进行了一项双盲、随机、单中心研究。符合条件的女性为妊娠≥37周且接受急诊剖宫产的患者。参与者分别接受100μg卡贝缩宫素或5国际单位催产素。主要结局是临床医生确定的是否需要额外使用宫缩剂。次要结局包括估计失血量、手术前后血红蛋白下降情况以及输血需求。结果:2012年8月至2013年2月,共纳入114名女性。其中2名因接受全身麻醉而被排除在分析之外。59名患者接受了100μg卡贝缩宫素;53名接受了5国际单位催产素。两组中需要额外使用宫缩剂的女性数量无统计学显著差异:卡贝缩宫素组为22%,催产素组为13%(p = 0.323)。血红蛋白下降、估计失血量、产后出血率或输血率方面均无显著差异。
催产素和卡贝缩宫素在额外使用宫缩剂、估计失血量、血红蛋白下降和输血方面有相似表现。接受卡贝缩宫素的患者有额外使用宫缩剂的趋势,但无统计学显著性。本研究未发现使用卡贝缩宫素比催产素有优势。