Prophylactic Carbetocin during Elective Caesarean Section in High Risk group for Atonic Postpartum Hemorrhage
Journal Title: The Egyptian Journal of Hospital Medicine - Year 2018, Vol 72, Issue 1
Abstract
<span>Background</span><span>: Postpartum hemorrhage (PPH) is defined as a blood loss more than 500 ml and serious PPH as a blood loss more than 1,000 ml. PPH is a serious condition remaining the single main cause of maternal morbidity and mortality. Postpartum hemorrhage (PPH) accounts for nearly one-quarter of all maternal deaths worldwide and was the second most frequent cause of maternal death in the UK for the 2000</span><span>–</span><span>2002 trienniums. </span> <span>The most frequent cause of PPH is uterine a tony, contributing up to 80 % of the PPH cases. Although two-thirds of the PPH cases occur in women without predisposing factors, there are several risk factors for PPH such as previous PPH, preeclampsia, coagulopathy, multiple gestation and antepartum hemorrhage. Also cesarean section (CS) is a recognized risk factor for PPH and its prevalence is increasing .The administration of oxytocics after the delivery of the neonate reduces the like hood of PPH and 5 IU oxytocin by slow intravenous injection is currently recommended in the UK for all cesarean sections. However, the use of additional oxytocic medication is common to arrest bleeding, or prophylactically if there are risk factors for PPH. Oxytocin is currently the uterotonic of first choice. It has proven to decrease the incidence of PPH by 40 % and has a rapid onset of action and a good safety profile . A disadvantage of oxytocin is its short half life of 4</span><span>–</span><span>10 min, regularly requiring a continuous intravenous infusion or repeated intramuscular injections. </span><span>Objectives</span><span>: was.to evaluate role of carbetocine either i.v or intramyometriam in preventing postpartum haemorrhge. </span><span>Patients and methods: </span><span>this was Randomized controlled double blind study was held at sayed galal hospital department of obstetrics and gynecology between April 2016 to October 2017 .<br /> </span><span>Results</span><span>: </span><span>We observe fall in rate of atonic postpartum haemorrhage after administration of carbetocin either i.v. or intramyometriaum . we found diferrance in blood pressure between two group weher increase og blood pressure in group received carbetocine i.v. .Also we found difference between two group need for additional dose which increase in goup that received carbetocine intramyometraim.<br /> </span><span>Conclusion</span><span>: Adminstration of carbetocine either i.v. or intramyometriaum decrease rate of atonic post partum haemorrhage in high risk group for atonic postpartum haemorrhage.<br /> </span>
Authors and Affiliations
Eman Helal
Keywords
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