The impact of routine carbetocin use at caesarean section. (16th November 2010)

• Record Type: Journal Article
• Authors: Stern, V; Naaisa, F; Strachan, B
• Is Part Of: Archives of disease in childhood. Volume 95(2010)Supplement 1
• Page Start: Fa66
• Page End: Fa66
• Publication Date: 2010-11-16
• Subjects: Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/adc.2010.189605.11
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Background: Carbetocin is a long-acting oxytocin agonist. Studies suggest it is as effective as oxytocin at preventing postpartum haemorrhage (PPH) and reduces the need for additional uterotonic agents. St Michael's Hospital is a tertiary centre with 5000 deliveries/year. The authors were the first UK unit to use carbetocin at all Caesarean sections and describe our experiences here. Methods: The authors introduced the routine use of carbetocin for all LSCS (lower segment Caesarean section) in May 2009. A retrospective cohort analysis was performed to assess the effect of this. The notes of all 755 patients undergoing LSCS from January–April to June–September were examined. Their weight and pre- and postoperative haematocrit were used to produce calculated blood loss (CBL) results. A sample size calculation demonstrated that the authors would need 250 patients in each arm to show a difference of 250 ml. Results: There was no difference in CBL in the carbetocin group (Student t=−1.0 p=0.37) and their chance of major PPH (>1 L) was not significantly increased with a calculated odds ratio of 1.07 (95% CI 0.76 to 1.5; χ 2 =0.1). Before After Group size 373 382 Complete data 328 (88%) 329 (86%) % Primips 149/373 (40%) 166/383 (43%) Mean CBL 726 ml (SD 546) 771 ml (SD 584) CBL ≥1 L 92 (28%) 97 (29% Conclusion: The routine use of carbetocin has safely been introduced in our unit. It has not increased blood loss at Caesarean section. Further analysis is necessary to assess wider effects of its introduction such as reduced need for syntocinon infusion.