Effects of Stepwise Carbetocin Administration on Postpartum Hemorrhage after Prelabor Cesarean Delivery
1
Issued Date
2025-07-01
Resource Type
eISSN
22288082
Scopus ID
2-s2.0-105013487947
Journal Title
Siriraj Medical Journal
Volume
77
Issue
7
Start Page
513
End Page
522
Rights Holder(s)
SCOPUS
Bibliographic Citation
Siriraj Medical Journal Vol.77 No.7 (2025) , 513-522
Suggested Citation
Buppawong P., Lertbunnaphong T., Limsiri P., Phetses A., Nivatpumin P., Triyasunant N. Effects of Stepwise Carbetocin Administration on Postpartum Hemorrhage after Prelabor Cesarean Delivery. Siriraj Medical Journal Vol.77 No.7 (2025) , 513-522. 522. doi:10.33192/smj.v77i7.273108 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/111793
Title
Effects of Stepwise Carbetocin Administration on Postpartum Hemorrhage after Prelabor Cesarean Delivery
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Corresponding Author(s)
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Abstract
Objective: To evaluate the effectiveness of stepwise administration of carbetocin in reducing postpartum hemorrhage (PPH) in term pregnancies undergoing elective cesarean delivery. Materials and Methods: This study included term pregnancies scheduled for cesarean delivery. Exclusion criteria were a BMI ≥ 35 kg/m2 , any underlying medical conditions that contraindicated the use of carbetocin and conditions affecting uterine contraction. Following newborn delivery, an initial dose of 50 µg of carbetocin was administered, with a subsequent 50 µg given if uterine contraction was inadequate. The primary outcome was the incidence of PPH exceeding 500 mL, while secondary outcomes included total blood loss ≥ 1,000 mL, administration of additional uterotonic agents, adverse effects, other pregnancy-related and surgical outcomes. Results: Of the 152 pregnant women analyzed, adequate uterine contraction was observed in 69.7% of cases after the first carbetocin dose, with an additional 19.7% achieving adequate contraction after the second dose. Estimated blood loss exceeding 500 mL was 32.9% and exceeding 1,000 mL was 2.0% of cases, respectively. Recalculations based on pre- and post-hematocrit levels indicated higher rates of blood loss: more than 500 mL in 45.4% and over 1,000 mL in 13.8%. No serious adverse events or complications were reported. Conclusion: The stepwise regimen demonstrated an effectiveness of 69.7% in preventing postpartum hemorrhage (PPH) during elective cesarean deliveries with the initial 50 µg dose, which increased to 89.4% following the administration of a second dose.