The objective of this study is to compare the effectiveness and safety of carbetocin vs. oxytocin plus sublingual misoprostol in the management of atonic postpartum hemorrhage (PPH)after vaginal delivery.
The first cause of hemorrhage at the time of delivery is uterine atony; therefore, there is general agreement that active management of the third stage of labor is recommended. Oxytocin is the most widely used uterotonic agent but has a half-life of only 4-10 min, that is why it is better administered as a continuous intravenous infusion to achieve sustained uterotonic activity. Carbetocin is a synthetic long-acting oxytocin agonistic analog with prolonged half-life prolonging its pharmacological effects. Its prolonged uterine activity may theoretically offer advantages over oxytocin in the management of the third stage of labor. The side-effect profile of carbetocin was not found to be different from that of Oxytocin but may prove to be advantageous when compared to Syntometrine.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
135
The patient will be received oxytocin 20 IU by intravenous infusion
The patient will be received oxytocin 20 IU by intravenous infusion plus 400 mic gm sublingual misoprostol
The patient received Carbetocin 100 mic gm
Aswan University Hospital
Aswān, Egypt
The amount of blood loss
calculation of the amount of blood loss by weighing the swabs and using pictorial charts
Time frame: 6 hours post delivery
The number of patients develop blood loss more than 1000 ml
Calculation of the number of patients develop blood loss more than 1000 ml
Time frame: 24 hours post delivery
The number of patient need blood transfusion
Calculation of number of patient need blood transfusion
Time frame: 24 hours post delivery
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