Chen Chih-Yao, Su Yi-Ning, Lin Tzu-Hung, Chang Yi, Horng Huann-Cheng, Wang Peng-Hui, Yeh Chang-Ching, Chang Wen-Hsun, Huang Hsin-Yi
Dianthus MFM Center Minquan, Dianthus MFM Group, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan.
Dianthus MFM Center Minquan, Dianthus MFM Group, Taipei, Taiwan.
Taiwan J Obstet Gynecol. 2016 Dec;55(6):804-809. doi: 10.1016/j.tjog.2016.07.009.
The aim of this retrospective observational study was to determine the efficacy of carbetocin in reducing blood loss and primary postpartum hemorrhage (PPH) in vaginal and cesarean deliveries in a tertiary hospital in Taiwan.
Eligible gravid women (27-41 weeks) with available data were categorized into those treated prophylactically with and without carbetocin. The primary outcome was blood loss and incidence of primary PPH as measured by intrapartum/intraoperative and postpartum (recovery room) blood loss.
A total of 1069 deliveries were evaluated. Maternal age (∼31 years of age), body mass index (∼27 kg/m) and parity (∼1.4) were similar among those treated with and without carbetocin for both vaginal and cesarean deliveries. The majority [749/1069 (70.1%)] of deliveries were vaginal; a similar proportion of women undergoing vaginal [221/749 (29.5%)] and cesarean [110/320 (34.4%)] deliveries received prophylactic carbetocin for prevention of PPH. Among vaginal deliveries, there was no significant difference in intrapartum (p = 0.083) or postpartum (p = 0.925) blood loss, or incidence of PPH (p = 0.092) between women with versus without carbetocin prophylaxis. However, there was a significant reduction in the intraoperative and total blood loss among cesarean deliveries with versus without carbetocin prophylaxis (p < 0.001). The incidence of PPH was higher [84/320 (26.3%)] among cesarean than among vaginal deliveries [62/749 (8.3%)], but was significantly lower among cesarean deliveries with [18 (16.36%)] versus without [66 (30.45%); p = 0.003] carbetocin prophylaxis.
In Taiwan, prophylactic use of carbetocin resulted in significantly less blood loss and incidence of PPH in cesarean than in vaginal deliveries.
这项回顾性观察研究的目的是确定在台湾一家三级医院中，卡贝缩宫素在减少阴道分娩和剖宫产术中失血及原发性产后出血（PPH）方面的疗效。
将有可用数据的符合条件的孕妇（孕周27 - 41周）分为接受和未接受卡贝缩宫素预防性治疗的两组。主要结局指标为通过产时/术中及产后（恢复室）失血量来衡量的失血量和原发性PPH的发生率。
共评估了1069例分娩。接受和未接受卡贝缩宫素治疗的阴道分娩和剖宫产孕妇的产妇年龄（约31岁）、体重指数（约27kg/m²）和产次（约1.4）相似。大多数[749/1069（70.1%）]分娩为阴道分娩；接受预防性卡贝缩宫素以预防PPH的阴道分娩[221/749（29.5%）]和剖宫产分娩[110/320（34.4%）]的女性比例相似。在阴道分娩中，接受与未接受卡贝缩宫素预防的女性在产时（p = 0.083）或产后（p = 0.925）失血量或PPH发生率（p = 0.092）方面无显著差异。然而，接受与未接受卡贝缩宫素预防的剖宫产分娩术中及总失血量有显著减少（p < 0.001）。剖宫产分娩的PPH发生率[84/320（26.3%）]高于阴道分娩[62/749（8.3%）]，但接受卡贝缩宫素预防的剖宫产分娩的PPH发生率[18（16.36%）]显著低于未接受预防的[66（30.45%）；p = 0.003]。
在台湾，预防性使用卡贝缩宫素导致剖宫产术中的失血量和PPH发生率显著低于阴道分娩。
