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Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT05742854
Other study ID # ASargin
Secondary ID
Status Not yet recruiting
Phase Phase 4
First received
Last updated
Start date March 9, 2023
Est. completion date June 21, 2023

Study information

Verified date March 2023
Source Ege University
Contact asuman sargin
Phone +905327498824
Email asuozdemir@hotmail.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Obstetric hemorrhage is the most common cause of maternal mortality worldwide and its incidence is estimated to be approximately 24%. A series of studies has shown that the risk of serious postpartum hemorrhage decreases with correct and active management in the third stage of labor. And the routine use of uterotonic agents underlies effective management. It has been reported that the routine use of uterotonic agents (oxytocin, carbetocin, ergometrine, etc.) reduces the risk of postpartum bleeding by 40% on average. However, the uterotonic agent and dose protocol are still unclear. Oxytocin is the most preferred agent for postpartum hemorrhage prophylaxis after vaginal and cesarean delivery in cases without risk factors, as it has a rapid onset of effect, does not increase blood pressure, and does not cause a retained placenta. In cases where oxytocin cannot be used, other agents of choice are ergot derivatives and misoprostol. The use of carbetocin, a long-acting oxytocin analogue, is now recommended in the guidelines for risky vaginal deliveries and postpartum hemorrhage prophylaxis after C-section. Carbetocin also reduces the need for additional uterotonics. Although carbetocin has been approved for use by the ministry of health, it still has limited clinical use in Turkey. It is vital for the medical community to have more experience with using carbetocin, an agent cited in medical guidelines and is also available in our country, and to share their experiences on academic platforms. This study intends to investigate oxytocin and carbetocin, which are uterotonic agents used during C-section, in terms of haemodynamic changes they cause, their effects on the uterine tone and on bleeding as well as their side effects (flushing, headache, back pain, hypertension and tachycardia, nausea-vomiting, etc.), to determine if there are any differences between them and share our insights with the reader.


Description:

Obstetric hemorrhage is the most common cause of maternal mortality worldwide and its incidence is estimated to be approximately 24%. A series of studies has shown that the risk of serious postpartum hemorrhage decreases with correct and active management in the third stage of labor. And the routine use of uterotonic agents underlies effective management. It has been reported that the routine use of uterotonic agents (oxytocin, carbetocin, ergometrine, etc.) reduces the risk of postpartum bleeding by 40% on average. However, the uterotonic agent and dose protocol are still unclear. Oxytocin is the most preferred agent for postpartum hemorrhage prophylaxis after vaginal and cesarean delivery in cases without risk factors, as it has a rapid onset of effect, does not increase blood pressure, and does not cause a retained placenta. In cases where oxytocin cannot be used, other agents of choice are ergot derivatives and misoprostol. The use of carbetocin, a long-acting oxytocin analogue, is now recommended in the guidelines for risky vaginal deliveries and postpartum hemorrhage prophylaxis after C-section. Carbetocin also reduces the need for additional uterotonics. Although carbetocin has been approved for use by the ministry of health, it still has limited clinical use in Turkey. It is vital for the medical community to have more experience with using carbetocin, an agent cited in medical guidelines and is also available in our country, and to share their experiences on academic platforms. This study intends to investigate oxytocin and carbetocin, which are uterotonic agents used during C-section, in terms of haemodynamic changes they cause, their effects on the uterine tone and on bleeding as well as their side effects (flushing, headache, back pain, hypertension and tachycardia, nausea-vomiting, etc.), to determine if there are any differences between them and share our insights with the reader.


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 200
Est. completion date June 21, 2023
Est. primary completion date May 31, 2023
Accepts healthy volunteers Accepts Healthy Volunteers
Gender Female
Age group 18 Years to 45 Years
Eligibility Inclusion Criteria: - 18-45 years old - Pregnant women to have a C-section, - Subjects with no history of oxytocin allergy, At term, no multiple pregnancies, elective C-section Exclusion Criteria: Subjects refusing to take part, - Subjects with a history of oxytocin allergy, Subjects scheduled for an emergency C-section, Multiple pregnancies, Having been diagnosed with diabetes mellitus

Study Design


Related Conditions & MeSH terms


Intervention

Procedure:
C-sections operations
Immediately after the delivery of the baby, uterotonic agents will be applied before the placenta is removed and by a manual check of the fundus of the uterus and the anterior wall, followed by an examination of the uterine tone by the surgeon
Drug:
Oxytocin
Oxytocin
Carbetocin
Carbetocin

Locations

Country Name City State
Turkey EÜTF Bornova I?zmi?r

Sponsors (1)

Lead Sponsor Collaborator
Ege University

Country where clinical trial is conducted

Turkey, 

Outcome

Type Measure Description Time frame Safety issue
Primary Effect of uterotonic agents on uterine tone uterine tone (standardized as Very good, Good, Sufficient, Atony), intraoperative
Primary hemorrhage haemoglobin concentration haemoglobin levels before and after 6 hours.
Secondary in terms of haemodynamic changes uterotonic agents cause Blood pressure (in mmHg),hypotansion intraoperative time, after 30 minute
Secondary side effects of uterotonic agents lushing, headache, back pain, hypertension and tachycardia, nausea-vomiting postoperative,24 hours after caesarean section
See also
  Status Clinical Trial Phase
Completed NCT03959436 - Database Evaluating Outcomes of Using Carbetocin as the Primary Uterotonic Following Cesarean Delivery