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Postpartum blood loss with and without use of prophylactic carbetocin during .. Carbetocin versus oxytocin for the prevention of postpartum haemorrhage. Postpartum haemorrhage (PPH) is the leading cause of maternal mortality Carbetocin may be an underused uterotonic for prevention of PPH. Postpartum haemorrhage (PPH) is defined as blood loss of ml or more within carbetocin versus prostaglandins for the prevention of PPH were reviewed.

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Carbetocin, a long-acting oxytocin agonist, appears to be a promising agent for the prevention of PPH.

Of the five identified studies in which IM oxytocin was used as a comparator womenthree of these studies women compared the fixed dose combination of oxytocin-ergometrine versus 10 IU of IM oxytocin. For women in the postoperative period after the surgical repair of a simple obstetric urinary fistula, short duration bladder catheterization 7 to 10 days is recommended as an alternative to longer duration of catheterization.

Systematic reviews comparing the effects of oxytocin versus ergometrine, a fixed dose combination of oxytocin versus ergometrine, and carbetocin versus prostaglandins for the prevention of PPH were reviewed. One Cochrane systematic review was conducted to assess the effectiveness and safety of any intervention used for the treatment of primary PPH.

Mousa HA, Alfirevic Z. Among the adverse outcomes rated as important, the comparison of oxytocin versus ergometrine or derivatives showed a lower rate of adverse effects in women treated with oxytocin only, as well as lower rates of nausea RR 0.

Active management of the third stage of labour has been proven to be effective in the prevention of PPH. You may also want to read RHL Article.

If IV oxytocin has been used for the treatment of PPH and preventinf bleeding does not stop, there is a paucity of data to recommend preferences for second line uterotonic drug treatment. Implementation considerations The successful introduction of evidence-based policies related to the prevention and management of PPH into national programmes and health care services depends on well-planned and participatory consensus-driven processes of adaptation and implementation.


No differences in blood transfusion in women receiving oxytocin compared carvetocin women receiving ergometrine RR 3.

Daily iron supplementation in infants and children. Medical eligibility criteria for contraceptive use MECthe first edition of which was published inpresents current WHO guidance on the safety of various contraceptive methods for use in the context This video demonstrates the methods for examination of the placenta.

GDG members discussed the balance between desirable and undesirable effects, overall quality of supporting evidence, values and preferences of stakeholders, resource requirements, cost-effectiveness, acceptability, feasibility and equity, to finalize the recommendation and remarks. The trials did not report the outcome of invasive or surgical treatment. No difference was observed in the risk of blood loss, the additional use of uterotonics, or the need for blood transfusion.

Oxytocin agonists for preventing postpartum haemorrhage. WHO recommendation on postnatal discharge following uncomplicated vaginal birth. WHO recommendations for the prevention and treatment of postpartum haemorrhage. Evidence related to the use of various uterotonics was extrapolated from research on the prevention of PPH. Pooled data also showed that carbetocin resulted in a lower risk of PPH compared to oxytocin in women who underwent caesarean delivery RR 0.

WHO recommendation on the use of uterotonics for the treatment of postpartum haemorrhage (PPH)

Doses of hamorrhage used ranged from 2 IU to 10 IU, while the fixed drug combination doses consisted of 5 IU of oxytocin and 0. There was no statistically significant difference in terms of the need for therapeutic uterotonic agents, but the risk of adverse effects such as nausea and vomiting were significantly lower in the carbetocin group: Including this trial in the meta-analysis changes the results RR 0.

A guide for essential practice. WHO haemorhage on interventions to improve preterm birth outcomes. Prophylactic oxytocin for the third stage of labour to prevent postpartum haemorrhage.

Carbetocin for preventing postpartum haemorrhage.

Cochrane Database of Systematic Postpartym. The use of uterotonics oxytocin alone as the first choice plays a central role in the treatment of PPH.


Active management of third stage of labour Education material for teachers of midwifery. Treatment of post-partum haemorrhage with sublingual misoprostol versus oxytocin in women receiving prophylactic oxytocin: Two studies reported a statistically significant lower use of additional uterotonics in the group receiving the fixed dose oxytocin-ergometrine combination RR 0.

The recommendation should be adapted into locally-appropriate documents and tools that are able to meet the specific needs of each country and health service. In the three studies that reported on the use of blood transfusion, the effect was uncertain as the confidence interval included both benefit and harm RR 1.

The majority could be prevented through the use fkr prophylactic uterotonics during the third stage of labour, and by timely and appropriate management.

Update of Cochrane Database Syst Rev. This is, however, limited by the number of studies and risk of bias in the studies. Background Postpartum haemorrhage PPH is defined as blood loss of ml or more within 24 hours after birth.

We checked references of articles and communicated with authors and pharmaceutical industry contacts.

Skip to main content. Among the important adverse maternal outcomes reported, lower rates of nausea RR 0. Comparison between carbetocin and syntometrine showed a lower mean blood loss in women who received carbetocin compared to syntometrine mean difference Postpartu, There was no statistically significant difference between the two groups with regard to blood loss, the use of blood transfusion, or the use of additional uterotonics.

In settings where IV oxytocin is unavailable to women who have received prophylactic IM oxytocin during the third stage of labour, the GDG considered misoprostol to be a valid alternative.