Postpartum Hemorrhage Clinical Trial
Official title:
Carbetocin at Elective Cesarean Delivery: A Dose Finding Study
Post-partum hemorrhage (PPH) is a major cause of maternal death worldwide. Oxytocin is the
most commonly uterotonic drug used to prevent and treat PPH in North America, however, there
are some limitations to its use. Oxytocin has a very short duration of action, which
requires a continuous infusion to achieve sustained uterotonic activity. The Society of
Obstetricians and Gynecologists of Canada (SOGC) has recently recommended a single 100mcg
dose of carbetocin at elective Cesarean delivery to promote uterine contraction and prevent
post partum hemorrhage (PPH), in lieu of the more traditional oxytocin regimens. Carbetocin
lasts 4 to 7 times longer than oxytocin, with a similar side effect profile and apparent
greater efficacy rate. However, a dose response to determine the minimum effective dose of
carbetocin has not yet been published.
We hypothesize that a dose-response study will establish the minimum dose of carbetocin
required to produce appropriate contractility in 95% of the women (ED95) undergoing elective
cesarean delivery.
The Society of Obstetricians and Gynecologists of Canada (SOGC)recently recommended a 100mcg
intravenous bolus dose of carbetocin following Cesarean delivery. However, a dose response
study to determine the minimum effective dose of carbetocin has not yet been published.
Studies thus far show that carbetocin may be just as effective as oxytocin in promoting
uterine contraction, with a similar side effects profile. In addition, patients receiving
carbetocin may experience less blood loss, and require less additional uterotonics when
compared with oxytocin.
The results of this study will define the minimum required dose of carbetocin for uterine
contraction, thus minimizing unnecessary side effects, improving quality and safety of
patient care. It may also contribute in establishing carbetocin as a substitute to oxytocin
for elective cesarean section at our institution as well as others.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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