These authors contributed equally to the protocol, the study and the article.
Haemodynamic effects of carbetocin and oxytocin given as intravenous bolus on women undergoing caesarean delivery: a randomised trial
Article first published online: 14 JUN 2011
© 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 118, Issue 11, pages 1349–1356, October 2011
How to Cite
Moertl, M., Friedrich, S., Kraschl, J., Wadsack, C., Lang, U. and Schlembach, D. (2011), Haemodynamic effects of carbetocin and oxytocin given as intravenous bolus on women undergoing caesarean delivery: a randomised trial. BJOG: An International Journal of Obstetrics & Gynaecology, 118: 1349–1356. doi: 10.1111/j.1471-0528.2011.03022.x
- Issue published online: 9 SEP 2011
- Article first published online: 14 JUN 2011
- Accepted 3 April 2011. Published Online 14 June 2011.
Vol. 118, Issue 12, 1549, Article first published online: 11 OCT 2011
- Caesarean section;
- cardiovascular effects;
- postpartum haemorrhage
Please cite this paper as: Moertl M, Friedrich S, Kraschl J, Wadsack C, Lang U, Schlembach D. Haemodynamic effects of carbetocin and oxytocin given asintravenous bolus on women undergoing caesarean delivery: a randomised trial. BJOG 2011;118:1349–1356.
Objective This study compares the maternal heart rate effects of carbetocin and oxytocin during elective caesarean delivery.
Design Double blind randomised single centre study (1:1).
Setting University hospital providing intrapartum care.
Population Fifty-six women undergoing elective caesarean section after spinal anaesthesia.
Methods Haemodynamic parameters were measured non-invasively using the Task Force® Monitor 3040i system. Measurements were taken for 500 seconds upon administration of a slow intravenous bolus of the clinically recommended doses of 100 μg of carbetocin or 5 IU of oxytocin to prevent postpartum haemorrhage (PPH).
Main outcome measure Effect on maternal heart rate (HR).
Results Statistically indistinguishable haemodynamic effects were seen for both drugs, with a maximal effect at about 30–40 seconds: HR increased 17.98 ± 2.53 bpm for oxytocin and 14.20 ± 2.45 bpm for carbetocin. Systolic blood pressure (sBP) decreased (−26.80 ± 2.82 mmHg for oxytocin versus −22.98 ± 2.75 mmHg for carbetocin). Following the maximal effect, women treated with carbetocin recovered slowly to baseline values asymptotically (HR and BP), whereas women treated with oxytocin displayed a slight rebound bradycardia at 200 seconds (−6.8 ± 1.92 bpm). Patients under both treatments showed a similar profile of side effects without any indication of unexpected adverse effects.
Conclusion Both oxytocins have comparable haemodynamic effects and are uterotonic drugs with an acceptable safety profile for prophylactic use. Minimal differences in the recovery phase beyond 70 seconds are in keeping with the fact that carbetocin has an extended half-life compared with oxytocin.