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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Compared to oxytocin, carbetocin was associated with a reduced need for uterine massage following both caesarean delivery RR 0. An enabling environment for example, by widening the availability of uterotonicsshould be created for the use of this recommendation for example, by widening the availability of crystalloid solutionincluding changes in the behaviour of health care practitioners to enable the use of evidence-based practices.

World Health Organization; varbetocin WHO recommendations for the prevention and treatment of postpartum haemorrhage. Mousa HA, Alfirevic Z. Oxytocin versus ergometrine One Cochrane systematic review investigated the effects of prophylactic oxytocin versus placebo or no treatment versus ergot alkaloids: WHO recommendations on interventions to improve preterm birth outcomes.

Further research is needed to analyse the cost-effectiveness of carbetocin as a uterotonic agent.

Evidence summary One Posgpartum systematic review was conducted to assess the effectiveness and safety of any intervention used for the treatment of primary PPH. Misoprostol any route versus injectable uterotonics Evidence was extrapolated from one systematic review which evaluated a number of routes and doses of misoprostol versus injectable uterotonics for the prevention of PPH.

Active management of third stage of labour. Local professional societies may play important roles in this process and an all-inclusive and participatory process should be encouraged. PPH is the primary cause of nearly one-fifth of all maternal deaths globally.


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No differences in blood transfusion in women receiving oxytocin compared with women receiving ergometrine RR 3. Two studies women were identified which compared IV oxytocin versus a fixed dose IM oxytocin-ergometrine combination. Further information on procedures for developing this recommendation are available here.

Medical eligibility criteria for contraceptive use. WHO recommendation on postnatal discharge following uncomplicated vaginal birth.

Among the important adverse effects reported, IM prostaglandins were associated with a peventing risk of vomiting RR 2. Decisions in such situations must be guided by the experience of the provider, the availability of the drugs, and by known contraindications. This guideline provides global, evidence-informed recommendations on daily iron supplementation in infants and children, as a public-health intervention for the prevention of anaemia and iron deficiency.

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

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.

The primary audience for this guideline includes health-care professionals who are responsible for developing national and local health-care protocols and policies, as well as managers of maternal and child health programmes and policy-makers in all settings. Use of carbetocin resulted in a statistically significant reduction in the need for therapeutic uterotonics risk ratio RR 0. This association was not apparent for vaginal delivery RR 0.

Skip to main content. This document is part of the process for improving the quality of care in family planning. Most of these deaths occur during the first 24 hours after birth. Carbetocin, a long-acting oxytocin agonist, appears to be a promising agent for the prevention of PPH.

When compared to oxytocin, carbetocin was associated with a reduced use of additional uterotonic drugs after caesarean delivery RR 0. Cochrane Carbetlcin of Systematic Reviews. Oxytocin agonists for preventing postpartum haemorrhage.

It encourages health care decision-makers in these settings to strive to make oxytocin available. What is the minimum effective dose of misoprostol for the treatment of PPH?


Carbetocin for preventing postpartum haemorrhage.

Six trials compared carbetocin with oxytocin; four of these were conducted for women undergoing caesarean deliveries, one was for women following vaginal deliveries and one did not state the mode of delivery clearly. Pooled data also showed that carbetocin resulted in carbetoccin lower risk of PPH compared to oxytocin in women who underwent caesarean delivery RR 0. Cost-effectiveness of carbetocin was investigated by one study published as an abstract, with limited data.

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

Daily iron supplementation in infants and children.

Evidence was extrapolated from one systematic review which evaluated a number of routes and doses of misoprostol versus injectable uterotonics for the prevention of PPH. World Health Organization, No significant difference was observed between the two groups with regard to blood loss, the use of blood transfusion, or the use of additional uterotonics.

The systematic review reported a reduction in the risk of PPH, with the use preventimg carbetocin versus oxytocin for women who underwent caesarean section.

This is, however, limited fo the number of studies and risk of bias in the studies. Intravenous oxytocin alone is the recommended uterotonic drug for the treatment of PPH. Syntometrine is more effective than oxytocin but is associated with more side effects.

Doses of oxytocin used ranged from 2 IU to 10 IU, while the fixed drug combination doses consisted of 5 IU of oxytocin and 0.