Akhter P, Pal S N, Begum S
Dr Parul Akhter, Assistant Professor, Department of Gynae & Obs, Sir Salimullah Medical College, Mitford, Dhaka, Bangladesh.
Mymensingh Med J. 2018 Oct;27(4):793-797.
The third stage of labour is considered to be the most critical part of child birth due to the risk of post partum haemorrhage (PPH). To compare the effectiveness of carbetocin and oxytocin in the management of 3rd stage of labour in preventing post partum hemorrhage, this experimental clinical trial was conducted in the Department of Obstetrics and Gynecology, Sir Salimulla Medical College Hospital, Dhaka, Bangladesh from January 2015 to June 2016. Three hundred women undergoing normal vaginal delivery were consecutively enrolled. They were divided into two groups, one group was treated with carbetocin 100μg IV and another group was treated with oxytocin 10 unit IV. Post partum haemorrhage was developed in 23(15.3%) and 31(20.7%) patients in carbetocin and oxytocin groups respectively. Among these PPH patients, 17(73.9%) patients received oxytocin, 21(91.3%) patients received Ergometrin and 14(60.9%) patients received misoprostol in carbetocin group as additional drug. In oxytocin group 30(96.8) patients received ergometrin and 26(83.9) patients received misoprostol. Significantly higher number of patients was treated with balloon catheter in oxytocin group (77.4%) than carbetocin group (39.1%). Thirteen (41.9%) patients in oxytocin group and 4(17.4%) patients in carbetocin group needed to treat in ICU. In carbetocin Group I patient (4.3%) and in oxytocin Group II patients (6.5%) died. carbetocin is better than oxytocin in the management of 3rd stage of labour to prevent post partum haemorrhage (PPH).
由于产后出血（PPH）的风险，分娩的第三阶段被认为是分娩过程中最关键的部分。为比较卡贝缩宫素和缩宫素在预防分娩第三阶段产后出血中的有效性，于2015年1月至2016年6月在孟加拉国达卡的萨利穆拉爵士医学院医院妇产科进行了这项实验性临床试验。连续纳入300名接受正常阴道分娩的妇女。她们被分为两组，一组接受静脉注射100μg卡贝缩宫素治疗，另一组接受静脉注射10单位缩宫素治疗。卡贝缩宫素组和缩宫素组分别有23例（15.3%）和31例（20.7%）患者发生产后出血。在这些产后出血患者中，卡贝缩宫素组有17例（73.9%）患者接受了缩宫素治疗，21例（91.3%）患者接受了麦角新碱治疗，14例（60.9%）患者接受了米索前列醇作为额外药物治疗。在缩宫素组，30例（96.8%）患者接受了麦角新碱治疗，26例（83.9%）患者接受了米索前列醇治疗。缩宫素组接受球囊导管治疗的患者数量（77.4%）显著高于卡贝缩宫素组（39.1%）。缩宫素组有13例（41.9%）患者和卡贝缩宫素组有4例（17.4%）患者需要在重症监护病房治疗。卡贝缩宫素组有1例患者（4.3%）死亡，缩宫素组有2例患者（6.5%）死亡。在预防分娩第三阶段产后出血（PPH）方面，卡贝缩宫素比缩宫素效果更好。
