Medina AMS, Espinosa MA, Vázquez LA

Language: Spanish
References: 9
Page: 102-107
PDF size: 57.45 Kb.

ABSTRACT

Background: Obstetric hemorrhage is one of the most important causes of maternal mortality. The incidence of severe obstetric hemorrhage postpartum is 5 to 15%, with a mortality ratio of 1:1000. In 75 to 90% of cases it is secondary to uterine atony.
Objective: To compare the results of the use of carbetocin and oxytocin in the postpartum period to prevent the uterine hemorrhage in patients at risk for hypotonic or atonic uterus.
Patients and method: A prospective, comparative and cross-sectional study was carried out, which included pregnant patients who entered for interruption of pregnancy with risk factors for uterine weakness. In the group A (n=30), patients received 20 U of intravenous oxytocin; and in the group B (n=32), patients received 100 mcg of carbetocin in the postpartum stage.
Results: In the group A, the mean age was 28.3 years and in the group B was 28.9 years. The presence or absence of adequate uterine contractility in postpartum was valued; 21 patients in group A (70%) and 25 patients in group B (78.1%) had an adequate contractility. The average of transurgical bleeding for both groups was 670 ± 393.5 mL in the group A, and 667.5 ± 366.15 mL in the group B. The bleeding was higher than 1,000 mL in five patient of group B and in three of group A.
Conclusions: There was not statistically significant difference comparing the use of oxytocin and carbetocin. Uterine contractility, volume of bleeding and average age were similar in both groups.

REFERENCES

1. Mousa H. Treatment for primary postpartum haemorrhage (Cochrane Review). The Cochrane Library, vol.1 Oxford: Update Software: 2003.

2. AbouZahr C. Global burden of maternal death and disability. Br Med Bull 2003;67:1-11.

3. Hogberg U. The decline in maternal mortality in Sweden: the role of community midwifery. Am J Public Health 2004;94(8):1312-1319.

4. Martínez M. Protocolo para el tratamiento y prevención de las hemorragias obstétricas graves. Buenos Aires, Noviembre de 2007

5. Secretaría de Salud. Dirección General de Salud Reproductiva. Lineamiento técnico para la prevención, diagnóstico y manejo de la hemorragia obstétrica. 1ª ed. México: SSA, 1999.

6. Chong Y, Su L, Arulkumaran S. Current strategies for the prevention of postpartum haemorrhage in the third stage of labour. Curr Opin Obstet Gynecol 2004;16(2):143-150.

7. Barbarino MP, Barbarino A, Bayoumeu F, Bonnenfant MV, Judlin P. Hémorragies graves au cours de la grossesse et du post partum. Choc hémorragique. Encycl Méd Chir Obstétrique 1998;5082-A-10.

8. Dansereau J, Joshi A, Helewa M, Doran T, et al. Double-blind comparison of carbetocin versus oxytocin in prevention of uterine atony after cesarean section. Am J Obstet Gynecol 1999;180(3):670-676.

9. Boucher M, Nimrod C, Tawagi G. Carbetocin in injection vs oxytocin IV infusion for prevention of postpartum hemorrhage in women at risk following vaginal delivery. Am J Obstet Gynecol 2001;185(Suppl 6):S216.