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Helen A van der Nelson, Tim Draycott, Dimitrios Siassakos, Christopher W H Yau, Anthony J Hatswell
OBJECTIVE: To determine the economic impact of the introduction of carbetocin for the prevention of postpartum haemorrhage (PPH) at caesarean section, compared to oxytocin. STUDY DESIGN: The model is a decision tree conducted from a UK National Health Service perspective. 1500 caesarean sections (both elective and emergency) were modelled over a 12 month period. Efficacy data was taken from a published Cochrane meta-analysis, and costs from NHS Reference costs, the British National Formulary and the NHS electronic Medicines Information Tool...
January 3, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Chih-Yao Chen, Yi-Ning Su, Tzu-Hung Lin, Yi Chang, Huann-Cheng Horng, Peng-Hui Wang, Chang-Ching Yeh, Wen-Hsun Chang, Hsin-Yi Huang
OBJECTIVE: The aim of this retrospective observational study was to determine the efficacy of carbetocin in reducing blood loss and primary postpartum hemorrhage (PPH) in vaginal and cesarean deliveries in a tertiary hospital in Taiwan. MATERIALS AND METHODS: Eligible gravid women (27-41 weeks) with available data were categorized into those treated prophylactically with and without carbetocin. The primary outcome was blood loss and incidence of primary PPH as measured by intrapartum/intraoperative and postpartum (recovery room) blood loss...
December 2016: Taiwanese Journal of Obstetrics & Gynecology
B Nucci, Agm Aya, E Aubry, J Ripart
STUDY OBJECTIVE: The aim of the study was to compare the incidence of the use of additional uterotonics before and after the change of carbetocin to oxytocin for the prevention of postpartum hemorrhage after cesarean delivery in women with severe preeclampsia. DESIGN: This was an observational retrospective before-and-after study. SETTING: Operating room, postoperative recovery area. PATIENTS: Sixty women with severe preeclampsia undergoing cesarean delivery under spinal anesthesia; American Society of Anesthesiologists 3...
December 2016: Journal of Clinical Anesthesia
Santiago Carrillo-Gaucín, Luis Guillermo Torres-Gómez
BACKGROUND: In Mexico, during 2010, obstetric hemorrhage was second (19.6%) as a direct cause of maternal death. The aim of this paper is to evaluate the effect of oxytocin and carbetocin, in preventing postpartum hemorrhage in patients with risk factors for uterine atony. METHODS: Study type clinical trial, patients experiencing at least one of the risk factors for uterine atony included. Randomly, they were divided into two groups: one was given Oxytocin and other received Carbetocin...
2016: Revista Médica del Instituto Mexicano del Seguro Social
L S Meshykhi, M R Nel, D N Lucas
Carbetocin is a new synthetic analogue of oxytocin. It has a longer half life than oxytocin. This review examines the current evidence for the use of carbetocin as an alternative to oxytocin, as a first-line agent in the pharmacological management of the third stage of labour.
December 2016: International Journal of Obstetric Anesthesia
Jennifer E Jardine, Penny Law, Matthew Hogg, Deirdre Murphy, Khalid S Khan
PURPOSE OF REVIEW: Caesarean section rates are increasing across the world. Postpartum haemorrhage is a major cause of morbidity and mortality; major haemorrhage is more common after caesarean delivery. There is a wide range of practice in the prevention and treatment of postpartum haemorrhage at caesarean section. The aim of this review is to summarize current opinion in the management of postpartum haemorrhage at caesarean section. RECENT FINDINGS: Recent large randomized controlled trials have shown a possible effect from the routine use of tranexamic acid and ergometrine...
December 2016: Current Opinion in Obstetrics & Gynecology
Maciej Sobkowski, Zbigniew Celewicz, Jarosław Kalinka, Krzysztof Szymanowski, Marcin Serafin, Katarzyna Śmieja, Anna Grzymała-Figura, Kinga Pacocha, Izabela Pieniążek, Jacek Walczak, Agnieszka Żyła, Adam Bierut
OBJECTIVES: The aim of this study was to compare the costs of using carbetocin in the prevention of uterine atony following delivery of the infant by Cesarean section (C-section) under epidural or spinal anesthesia with standard methods of prevention (SMP). MATERIAL AND METHODS: This retrospective multicenter study was based on data from three medical centers. A questionnaire was developed to gather patient records on consumption and costs of resources related to C-section, prevention of uterine atony and postpartum hemorrhage (PPH) treatment...
2016: Ginekologia Polska
Sung Hye Byun, So Young Lee, Seong Yeon Hong, Taeha Ryu, Baek Jin Kim, Jin Yong Jung
INTRODUCTION: In fetuses who are predicted to be at risk of catastrophic airway obstruction at delivery, the ex utero intrapartum treatment (EXIT) procedure is useful for securing the fetal airway while maintaining fetal oxygenation via placental circulation. Factors, including poor posture of the fetus and physician, narrow visual field, and issues of contamination in the aseptic surgical field, make fetal intubation during the EXIT procedure difficult. Herein, we report our experience of the usefulness of the GlideScope video laryngoscope (GVL) for intubation during the EXIT procedure...
September 2016: Medicine (Baltimore)
Mohammad Ahmed Maher, Tarek Mohammad Sayyed, Nabih Ibrahim Elkhouly
OBJECTIVES: To compare between three different utertonics (oxytocin, carbetocin, and misoprostol) given via three different routes (intra-umbilical, intravenous, and sublingual, respectively) in reducing the need for manual removal of placenta. METHODS: A randomized trial for cases with retained placenta 30 minutes following vaginal delivery. They received intraumbilical oxytocin, intravenous carbetocin, or sublingual misoprostol. Main outcome measures were delivery of the placenta within 30 minutes following drug administration, and need for manual removal of placenta...
September 27, 2016: Journal of Maternal-fetal & Neonatal Medicine
(no author information available yet)
BestBETs for Vets are generated by the Centre for Evidence-based Veterinary Medicine at the University of Nottingham to help answer specific questions and assist in clinical decision making. Although evidence is often limited, they aim to find, present and draw conclusions from the best available evidence, using a standardised framework. A more detailed description of how BestBETs for Vets are produced was published in VR, April 4, 2015, vol 176, pp 354-356.
August 13, 2016: Veterinary Record
John J Morrison, David A Crosby, Denis J Crankshaw
Uterine atony is a major cause of postpartum haemorrhage and maternal mortality. However, the comparative pharmacology of agents used to treat this condition is poorly understood. This study evaluates, using human pregnant myometrium in vitro, a range of contractile parameters for agents used in the clinical treatment of atonic postpartum haemorrhage. The effects of oxytocin, carbetocin, ergometrine, carboprost, syntometrine and misoprostol were investigated in 146 myometrial strips from 19 donors. The potency and maximal response values were obtained, and compared, using both maximal amplitude and mean contractile force as indices of contraction...
October 15, 2016: European Journal of Pharmacology
Ahmed E H Elbohoty, Walid E Mohammed, Mohamed Sweed, Ahmed M Bahaa Eldin, Ashraf Nabhan, Karim H I Abd-El-Maeboud
OBJECTIVE: To compare the effectiveness and safety of carbetocin, misoprostol, and oxytocin for the prevention of postpartum hemorrhage following cesarean deliveries. METHODS: A double-blind randomized controlled trial enrolled patients with a singleton pregnancy scheduled for an elective cesarean delivery at a maternity hospital in Cairo, Egypt, between October 1, 2012 and June 30, 2013. Participants were randomized using a computer-generated sequence to receive treatment with carbetocin, misoprostol, or oxytocin...
September 2016: International Journal of Gynaecology and Obstetrics
Ahmed Mohamed Maged, Ahmed Shaker Ragab, Noura Elnassery, Walaa Ai Mostafa, Sherif Dahab, Amal Kotb
OBJECTIVE: To compare effectiveness and tolerability of carbetocin versus syntometrine in prevention of postpartum hemorrhage (PPH) after cesarean section (CS). METHODS: A double-blind randomized study conducted on 300 pregnant subjected randomly either to single 100 μg IV dose of carbetocin (150 women) or combination of 5 IU oxytocin and 0.2 mg ergometrine (150 women) after fetal extraction and before placental removal. Primary outcome parameter was the occurrence of PPH...
June 8, 2016: Journal of Maternal-fetal & Neonatal Medicine
Fernanda Francine Zimmermann, Karina Vidarte Gaspary, Anna Maria Siebel, Carla Denise Bonan
Changes in social behavior occur in several neuropsychiatric disorders such as schizophrenia and autism. The interaction between individuals is an essential aspect and an adaptive response of several species, among them the zebrafish. Oxytocin is a neuroendocrine hormone associated with social behavior. The aim of the present study was to investigate the effects of MK-801, a non-competitive antagonist of glutamate NMDA receptors, on social interaction and aggression in zebrafish. We also examined the modulation of those effects by oxytocin, the oxytocin receptor agonist carbetocin and the oxytocin receptor antagonist L-368,899...
September 15, 2016: Behavioural Brain Research
Benjamin Deniau, Nacima Bouhadjari, Valentina Faitot, Antoine Mortazavi, Gilles Kayem, Laurent Mandelbrot, Hawa Keita
OBJECTIVE: To assess the performance of a multidisciplinary programme for enhanced recovery after caesarean delivery under neuraxial anaesthesia. STUDY DESIGN: Prospective single-centre study. METHODS: Programme in 6 steps including 3 professional practice audits based on clinical records and questioning patients: audit T0, first "existing state", creation of a working group, drafting and implementation of a multidisciplinary rehabilitation procedure, second audit (T0+4 months), information about and implementation of corrective measures and a third audit (T0+8 months)...
December 2016: Anaesthesia, Critical Care & Pain Medicine
Salome Dell-Kuster, Irene Hoesli, Olav Lapaire, Esther Seeberger, Luzius A Steiner, Heiner C Bucher, Thierry Girard
BACKGROUND: The two most commonly used uterotonic drugs in caesarean section are oxytocin and carbetocin, a synthetic oxytocin analogue. Carbetocin has a longer half-life when compared to oxytocin, resulting in a reduced use of additional uterotonics. Oxytocin is known to cause fewer cardiovascular side effects when administered as a short-infusion compared to as an intravenous bolus. Based on these findings, we aim at comparing carbetocin 100 mcg given as a slow intravenous bolus with carbetocin 100 mcg applied as a short-infusion in 100 ml 0...
March 22, 2016: Trials
Mariana Widmer, Gilda Piaggio, Hany Abdel-Aleem, Guillermo Carroli, Yap-Seng Chong, Arri Coomarasamy, Bukola Fawole, Shivaprasad Goudar, G Justus Hofmeyr, Pisake Lumbiganon, Kidza Mugerwa, Thi My Huong Nguyen, Zahida Qureshi, Joao Paulo Souza, A Metin Gülmezoglu
BACKGROUND: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality in low-income countries and contributes to nearly a quarter of maternal deaths globally. The current available interventions for prevention of postpartum haemorrhage, oxytocin and carbetocin, are limited by their need for refrigeration to maintain potency, as the ability to maintain a cold chain across the drug distribution and storage network is inconsistent, thus restricting their use in countries with the highest burden of maternal mortality...
March 17, 2016: Trials
Xiaolu Meng, Fang Shen, Chunlu Li, Yonghui Li, Xuewei Wang
Tree shrews, a species phylogenetically close to primates, are regarded as a suitable and naturalistic animal model for depression studies. However, psychological symptoms that are essential for depression diagnosis and treatment, such as helplessness and social withdrawal, have not been studied in this model. Therefore, in this study, we first investigated learned helplessness, social interaction and sucrose preference induced by two chronic stress paradigms: uncontrollable foot shocks (1-week foot shocks) and multiple unpredictable stimuli (1-week foot shocks and 3-week unpredictable stressors) in tree shrews...
June 2016: Pharmacology, Biochemistry, and Behavior
Carole-Anne Whigham, Alexandra Gorelik, Terrence E Loughnan, Amar Trivedi
OBJECTIVE: We compared the efficacy of Carbetocin (long-acting oxytocin receptor agonist) versus Oxytocin given at non-elective caesarean section. METHOD: We performed a double-blind, randomised, single-centre study. Eligible women were ≥37 weeks of gestation undergoing emergency caesarean section. Participants received either carbetocin of 100 μg or oxytocin 5 international units. The primary outcome was the need to administer additional uterotonics, as determined by the clinician...
December 2016: Journal of Maternal-fetal & Neonatal Medicine
P P Tang, H Y Hu, J S Gao, J Hu, Y F Zhong, T Wang, Y N Song, X Y Zhou, J Q Yang, J T Liu, J Pan, H F Shi
OBJECTIVE: To evaluate the efficacy and safety of pelvic arterial embolization (PAE) in women with intractable primary postpartum hemorrhage (PPH). METHODS: Clinical data of 36 cases were analyzed retrospectively in which women underwent PAE for intractable primary PPH in Peking Union Medical College Hospital between Jan 2006 and Jan 2015. The success rate of PAE were measured and possible predictive risk factors associated with treatment failure were analyzed. The complications secondary to PAE were also recorded...
February 2016: Zhonghua Fu Chan Ke za Zhi
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