Carbetocin versus Rectal Misoprostol to Decrease Blood Loss in Vaginal Delivery in High Risk Patients for Postpartum Hemorrhage

Background: Postpartum hemorrhage is a critical complication after delivery. Methods to decrease or prevent postpartum hemorrhage continue to develop. The medical prophylaxis is frequently used with extension of the utilized drugs.Aim of the work: The current study aims to evaluate the effects of in...

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Autores principales:	Yasmin Abd-Elmoaty Abdo Mohamed Hetiba, Mahmoud Mahmoud, Abd Elraouf Mohammad Oun
Formato:	article
Lenguaje:	EN
Publicado:	Al-Azhar University, Faculty of Medicine (Damietta) 2021
Materias:	postpartum hemorrhage carbetocin misoprostol vaginal delivery Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/7325ee1a622c4889ad1210b26bf5bbf0
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spelling	oai:doaj.org-article:7325ee1a622c4889ad1210b26bf5bbf02021-12-02T18:11:21ZCarbetocin versus Rectal Misoprostol to Decrease Blood Loss in Vaginal Delivery in High Risk Patients for Postpartum Hemorrhage2636-41742682-378010.21608/ijma.2021.86685.1342https://doaj.org/article/7325ee1a622c4889ad1210b26bf5bbf02021-10-01T00:00:00Zhttps://ijma.journals.ekb.eg/article_203355_906ca319f90a5fcde3f650e103c82608.pdfhttps://doaj.org/toc/2636-4174https://doaj.org/toc/2682-3780Background: Postpartum hemorrhage is a critical complication after delivery. Methods to decrease or prevent postpartum hemorrhage continue to develop. The medical prophylaxis is frequently used with extension of the utilized drugs.Aim of the work: The current study aims to evaluate the effects of intravenous carbetocin versus rectal misoprostol to decrease blood loss in vaginal delivery in high risk patients for postpartum hemorrhage.Patients and Methods: The study included 94 Patients. They were selected from those attending for normal vaginal delivery and categorized as high risk for postpartum hemorrhage. All were evaluated on clinical basis, laboratory investigations and abdominal ultrasound. Then patients were randomly assigned into two equal groups; group A [Carbetocin group] received 1 ampoule of Carbetocin [100 μg/ml] intravenously as a bolus injection slowly over one minute after neonatal delivery, and group B [Misoprostol group] received three rectal misoprostol tablets [600 μg] after neonatal delivery. Each group was assessed for hemodynamic changes [blood pressure, pulse and respiratory rate], gastrointestinal [GIT] side effects as nausea, vomiting and metallic taste, vasomotor effects as flushing, headache, itching.Results: The amount of blood loss was significantly lower in the carbetocin group than in the misoprostol group [365.53±41.12 ml vs. 404.68±67.27 ml]. Need for uterotonics reported among 17.0% of misoprostol group compared to none [0.0%] in carbetocin group [P=0.003]. On the other side, need for blood transfusion and uterine massage was also increased in misoprostol than carbetocin groups, but the difference was not statistically significant. The complications [drug side effects] revealed that, there was significant increase of fever, nausea & vomiting, diarrhea and abdominal pain in misoprostol than carbetocin group [21.3%, 10.6%, 19.14% and 21.3% vs. 0.0%, 0.0%, 2.12% and 0.0% successively].Conclusion: Carbetocin is superior to misoprostol for postpartum hemorrhage, regarding efficacy and safety.Yasmin Abd-Elmoaty Abdo Mohamed HetibaMahmoud MahmoudAbd Elraouf Mohammad OunAl-Azhar University, Faculty of Medicine (Damietta)articlepostpartumhemorrhagecarbetocinmisoprostolvaginal deliveryMedicine (General)R5-920ENInternational Journal of Medical Arts, Vol 3, Iss 4, Pp 1923-1929 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	postpartum hemorrhage carbetocin misoprostol vaginal delivery Medicine (General) R5-920
spellingShingle	postpartum hemorrhage carbetocin misoprostol vaginal delivery Medicine (General) R5-920 Yasmin Abd-Elmoaty Abdo Mohamed Hetiba Mahmoud Mahmoud Abd Elraouf Mohammad Oun Carbetocin versus Rectal Misoprostol to Decrease Blood Loss in Vaginal Delivery in High Risk Patients for Postpartum Hemorrhage
description	Background: Postpartum hemorrhage is a critical complication after delivery. Methods to decrease or prevent postpartum hemorrhage continue to develop. The medical prophylaxis is frequently used with extension of the utilized drugs.Aim of the work: The current study aims to evaluate the effects of intravenous carbetocin versus rectal misoprostol to decrease blood loss in vaginal delivery in high risk patients for postpartum hemorrhage.Patients and Methods: The study included 94 Patients. They were selected from those attending for normal vaginal delivery and categorized as high risk for postpartum hemorrhage. All were evaluated on clinical basis, laboratory investigations and abdominal ultrasound. Then patients were randomly assigned into two equal groups; group A [Carbetocin group] received 1 ampoule of Carbetocin [100 μg/ml] intravenously as a bolus injection slowly over one minute after neonatal delivery, and group B [Misoprostol group] received three rectal misoprostol tablets [600 μg] after neonatal delivery. Each group was assessed for hemodynamic changes [blood pressure, pulse and respiratory rate], gastrointestinal [GIT] side effects as nausea, vomiting and metallic taste, vasomotor effects as flushing, headache, itching.Results: The amount of blood loss was significantly lower in the carbetocin group than in the misoprostol group [365.53±41.12 ml vs. 404.68±67.27 ml]. Need for uterotonics reported among 17.0% of misoprostol group compared to none [0.0%] in carbetocin group [P=0.003]. On the other side, need for blood transfusion and uterine massage was also increased in misoprostol than carbetocin groups, but the difference was not statistically significant. The complications [drug side effects] revealed that, there was significant increase of fever, nausea & vomiting, diarrhea and abdominal pain in misoprostol than carbetocin group [21.3%, 10.6%, 19.14% and 21.3% vs. 0.0%, 0.0%, 2.12% and 0.0% successively].Conclusion: Carbetocin is superior to misoprostol for postpartum hemorrhage, regarding efficacy and safety.
format	article
author	Yasmin Abd-Elmoaty Abdo Mohamed Hetiba Mahmoud Mahmoud Abd Elraouf Mohammad Oun
author_facet	Yasmin Abd-Elmoaty Abdo Mohamed Hetiba Mahmoud Mahmoud Abd Elraouf Mohammad Oun
author_sort	Yasmin Abd-Elmoaty Abdo Mohamed Hetiba
title	Carbetocin versus Rectal Misoprostol to Decrease Blood Loss in Vaginal Delivery in High Risk Patients for Postpartum Hemorrhage
title_short	Carbetocin versus Rectal Misoprostol to Decrease Blood Loss in Vaginal Delivery in High Risk Patients for Postpartum Hemorrhage
title_full	Carbetocin versus Rectal Misoprostol to Decrease Blood Loss in Vaginal Delivery in High Risk Patients for Postpartum Hemorrhage
title_fullStr	Carbetocin versus Rectal Misoprostol to Decrease Blood Loss in Vaginal Delivery in High Risk Patients for Postpartum Hemorrhage
title_full_unstemmed	Carbetocin versus Rectal Misoprostol to Decrease Blood Loss in Vaginal Delivery in High Risk Patients for Postpartum Hemorrhage
title_sort	carbetocin versus rectal misoprostol to decrease blood loss in vaginal delivery in high risk patients for postpartum hemorrhage
publisher	Al-Azhar University, Faculty of Medicine (Damietta)
publishDate	2021
url	https://doaj.org/article/7325ee1a622c4889ad1210b26bf5bbf0
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Carbetocin versus Rectal Misoprostol to Decrease Blood Loss in Vaginal Delivery in High Risk Patients for Postpartum Hemorrhage

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