Department of Obstetrics and Gynecology, Foshan Chancheng Central Hospital, Foshan, Guangdong, China.
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
Pharmacol Res Perspect. 2021 Apr;9(2):e00745. doi: 10.1002/prp2.745.
Postpartum hemorrhage (PPH) increases the risk of maternal death worldwide. Heat-stable carbetocin, a long-acting oxytocin analog, is a newer uterotonic agent. Clinicians do not fully understand its side-effects, particularly the unanticipated side-effects. The aim of this study is to investigate the side-effects of carbetocin to PPH. The Cochrane Library, Web of Science, PubMed, Elsevier ScienceDirect, Embase, and ClinicalTrials.gov were searched from the inception to September 2020. Randomized controlled trials (RCTs) that considered pregnant women who received carbetocin before delivery and provided at least one adverse event were included. Statistical analysis included random or fixed-effect meta-analyses using relative risk. Stratified analyses and sensitivity analyses were also performed. Begger's and Egger's test and funnel plots were used to assess the publication bias. Seventeen RCTs involving 32,702 women were included, and all these studies ranked as medium- to high-quality. Twenty-four side-effects were reported. The use of carbetocin had a lower risk of vomiting in intravenously (0.53, 0.30 to 0.93) and cesarean birth (0.51, 0.32 to 0.81) women, and had a slightly higher risk of diarrhea (8.00, 1.02 to 62.79) compared with oxytocin intervention. No significant difference was found among other side-effects. Evidence from our systematic review and meta-analysis of 17 RCTs suggested that the risk of vomiting decreased with carbetocin use in the prevention of PPH after delivery.
产后出血（PPH）增加了全世界产妇死亡的风险。卡贝缩宫素是一种长效催产素类似物，是一种新型的子宫收缩剂。临床医生不完全了解其副作用，尤其是意外的副作用。本研究旨在探讨卡贝缩宫素治疗 PPH 的副作用。系统检索了 Cochrane 图书馆、Web of Science、PubMed、Elsevier ScienceDirect、Embase 和 ClinicalTrials.gov 从成立到 2020 年 9 月的数据。纳入了考虑在分娩前接受卡贝缩宫素并至少报告了一种不良事件的孕妇的随机对照试验（RCT）。统计分析包括使用相对风险的随机或固定效应荟萃分析。还进行了分层分析和敏感性分析。贝格和埃格检验和漏斗图用于评估发表偏倚。纳入了 17 项涉及 32702 名女性的 RCT，所有这些研究的质量均为中等到高度。报告了 24 种副作用。与催产素干预相比，卡贝缩宫素静脉给药（0.53，0.30 至 0.93）和剖宫产分娩（0.51，0.32 至 0.81）的女性发生呕吐的风险较低，腹泻的风险略高（8.00，1.02 至 62.79）。其他副作用之间没有发现显著差异。我们对 17 项 RCT 的系统评价和荟萃分析表明，卡贝缩宫素用于预防产后 PPH 可降低呕吐的风险。
