THE USE OF CARBETOCIN IN THE PREVENTION OF POSTPARTUM HEMORRHAGE: A LITERATURE REVIEW
DOI:
https://doi.org/10.47820/recima21.v5i8.5579Keywords:
Carbetocin. Postpartum hemorrhage. Clinical management.Abstract
Postpartum hemorrhage (PPH) is one of the leading causes of global maternal mortality, affecting approximately 5% of births. This condition is often caused by uterine atony, responsible for about 70% of cases, and is exacerbated by risk factors such as episiotomy and general anesthesia. The administration of effective uterotonics, such as oxytocin and carbetocin, plays a crucial role in reducing the risk of PPH, demonstrating a documented decrease of up to 66%. To investigate the efficacy of carbetocin in preventing PPH, 19 studies published from 2019 onwards were selected based on strictly relevant inclusion criteria. These studies highlighted carbetocin due to its superior thermal stability and comparative efficacy against other available uterotonics. Despite higher costs, its use potentially reduces significant obstetric complications and associated maternal health costs. Discussions emphasized the safety, efficacy, and feasibility of carbetocin in settings with logistical limitations, demonstrating its superior performance over oxytocin in various reviewed analyses. Despite economic challenges, cost-effectiveness studies supported its application, especially in high-risk deliveries and cesarean sections. Carbetocin stands out as a viable option, despite cost being a challenge, recommending its implementation in specific scenarios to improve obstetric outcomes and mitigate maternal mortality.
Downloads
References
AI, W. et al. Side‐effects of carbetocin to prevent postpartum hemorrhage: A systematic review and meta‐analysis of randomized controlled trials. Pharmacology Research & Perspectives, v. 9, n. 2, 15 mar. 2021. DOI: https://doi.org/10.1002/prp2.745
ALBAZEE, E. et al. Efficacy and Safety of Carbetocin Versus Misoprostol in Cesarean Section: A Systematic Review and Meta-Analysis. Cureus, 24 dez. 2022. DOI: https://doi.org/10.7759/cureus.32901
BARRETT, J.; KO, S.; JEFFERY, W. Cost Implications of Using Carbetocin Injection to Prevent Postpartum Hemorrhage in a Canadian Urban Hospital. Journal of Obstetrics and Gynaecology Canada, v. 44, n. 3, p. 272–278, 1 mar. 2022. DOI: https://doi.org/10.1016/j.jogc.2021.09.022
CETIN, C. et al. Carbetocin versus Oxytocin with or without Tranexamic Acid for Prophylactic Prevention of Postpartum Hemorrhage after a Vaginal Delivery: A Randomized Clinical Trial. Gynecologic and Obstetric Investigation, v. 88, n. 6, p. 366–374, 30 set. 2023. DOI: https://doi.org/10.1159/000534375
CHAO, Y.-S.; MCCORMACK, S. Carbetocin for the Prevention of Post-Partum Hemorrhage: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health, 2019.
COOK, J. R. et al. Cost-effectiveness and budget impact of heat-stable carbetocin compared to oxytocin and misoprostol for the prevention of postpartum hemorrhage (PPH) in women giving birth in India. BMC Health Services Research, v. 23, n. 1, 17 mar. 2023. DOI: https://doi.org/10.1186/s12913-023-09263-4
FEDUNIW, S. et al. Epidemiology, prevention and management of early postpartum hemorrhage — a systematic review. Ginekologia Polska, v. 91, n. 1, p. 38–44, 31 jan. 2020. DOI: https://doi.org/10.5603/GP.2020.0009
GALLOS, I. et al. Uterotonic drugs to prevent postpartum haemorrhage: a network meta-analysis. Health Technology Assessment, v. 23, n. 9, p. 1–356, fev. 2019. DOI: https://doi.org/10.3310/hta23090
GHOSH, R. et al. Heat stable carbetocin or oxytocin for prevention of postpartum hemorrhage among women at risk: A secondary analysis of the CHAMPION trial. International Journal of Gynecology & Obstetrics, v. 164, n. 1, p. 124–130, 26 jun. 2023. DOI: https://doi.org/10.1002/ijgo.14938
HSU, W.-W. et al. Uncontrolled before-after study adding carbetocin in addition to oxytocin decreases blood loss for cesarean section in twin pregnancies. Journal of the Formosan Medical Association, v. 120, n. 8, p. 1635–1641, ago. 2021. DOI: https://doi.org/10.1016/j.jfma.2021.01.020
HUANG, X. et al. Effect of Carbetocin on Postpartum Hemorrhage after Vaginal Delivery: A Meta-Analysis. Computational and Mathematical Methods in Medicine, v. 2022, p. 1–6, 20 jun. 2022. DOI: https://doi.org/10.1155/2022/6420738
JIN, X.-H.; LI, D.; LI, X. Carbetocin vs oxytocin for prevention of postpartum hemorrhage after vaginal delivery. Medicine, v. 98, n. 47, p. e17911, nov. 2019. DOI: https://doi.org/10.1097/MD.0000000000017911
JONES, A. J.; FEDERSPIEL, J. J.; EKE, A. C. Preventing postpartum hemorrhage with combined therapy rather than oxytocin alone pharmacologic therapy. American journal of obstetrics & gynecology MFM, v. 5, n. 2, p. 100731, 24 ago. 2022. DOI: https://doi.org/10.1016/j.ajogmf.2022.100731
JOYCE, H. S.; LEUNG, T. Cost-effectiveness analysis of carbetocin for prevention of postpartum hemorrhage in a low-burden high-resource city of China. Plos One, v. 17, n. 12, p. e0279130–e0279130, 15 dez. 2022. DOI: https://doi.org/10.1371/journal.pone.0279130
LI, Y.-T.; CHANG, W.-H.; WANG, P.-H. Postpartum hemorrhage. Taiwanese Journal of Obstetrics and Gynecology, v. 61, n. 1, p. 5–7, 1 jan. 2022. DOI: https://doi.org/10.1016/j.tjog.2021.11.003
MCDOUGALL, A. R. A. et al. Innovations in the prevention and treatment of postpartum hemorrhage: Analysis of a novel medicines development pipeline database. International Journal of Gynecology & Obstetrics, v. 158, n. S1, p. 31–39, jun. 2022. DOI: https://doi.org/10.1002/ijgo.14200
NELSON, H. et al. Intramuscular oxytocin versus Syntometrine ® versus carbetocin for prevention of primary postpartum haemorrhage after vaginal birth: a randomised double‐blinded clinical trial of effectiveness, side effects and quality of life. BJOG: An International Journal of Obstetrics & Gynaecology, v. 128, n. 7, 12 jan. 2021. DOI: https://doi.org/10.1111/1471-0528.16622
TRAN, N. T. et al. How to use heat-stable carbetocin and tranexamic acid for the prevention and treatment of postpartum haemorrhage in low-resource settings. BMJ Global Health, v. 7, n. 4, p. e008913, abr. 2022. DOI: https://doi.org/10.1136/bmjgh-2022-008913
TRAN, N. T. et al. Implementing Heat-Stable Carbetocin for Postpartum Haemorrhage Prevention in Low-Resource Settings: A Rapid Scoping Review. International Journal of Environmental Research and Public Health, v. 19, n. 7, p. 3765, 22 mar. 2022. DOI: https://doi.org/10.3390/ijerph19073765
Downloads
Published
How to Cite
License
Copyright (c) 2024 RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Os direitos autorais dos artigos/resenhas/TCCs publicados pertecem à revista RECIMA21, e seguem o padrão Creative Commons (CC BY 4.0), permitindo a cópia ou reprodução, desde que cite a fonte e respeite os direitos dos autores e contenham menção aos mesmos nos créditos. Toda e qualquer obra publicada na revista, seu conteúdo é de responsabilidade dos autores, cabendo a RECIMA21 apenas ser o veículo de divulgação, seguindo os padrões nacionais e internacionais de publicação.