卡贝菌素预防剖宫产产后出血:单中心经验和成本效益分析。

Harefuah Pub Date : 2025-07-01
Chen Ben David, Naphtali Justman, Ido Solt, Philippe Abecassis, Dana Vitner, Nizar Khatib, Zeev Weiner, Yaniv Zipori
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引用次数: 0

摘要

近年来,一种长效的催产素类似物,卡贝菌素,已被证明比常用的催产素具有临床优势。目的:评价卡贝菌素与催产素在预防剖宫产产后出血(PPH)中的临床和经济效益。方法:比较剖宫产术中应用催产素预防PPH前(组1,催产素时代)和后(组2,催产素时代)的围产儿结局。结果:与1组相比,2组PPH发生率明显降低,输血需血量降低(1%比4.1%,p=0.003),术后血红蛋白下降≥3g/dL(5.2%比10.3%,p=0.008)。给药红细胞数量(4个对27个单位,p=0.002)、出院时血红蛋白δ(1.3±0.9比1.6±1.2,p=0.002)、住院时间和再入院率均显著有利于卡贝菌素的使用。经济效益显著倾向于使用卡贝菌素(ILS分别为112,237 vs 125,106.5,成本差异为12,869.5)。结论:与常用的子宫张力催产素相比,卡贝菌素已被证明可以降低PPH的发生率,并具有成本效益。讨论:与催产素相比,卡贝菌素在剖宫产术中预防PPH有几个优势。临床和经济研究证据支持在剖宫产中常规应用卡贝菌素预防PPH。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[CARBETOCIN FOR THE PREVENTION OF POSTPARTUM HEMORRHAGE IN CESAREAN DELIVERIES: A SINGLE CENTER EXPERIENCE AND COST-EFFECTIVE ANALYSIS].

Introduction: In recent years, a long-acting Oxytocin analogue, Carbetocin, has been shown to offer clinical advantage over the commonly used Oxytocin.

Aims: To evaluate Carbetocin's clinical and financial benefits compared to Oxytocin in preventing postpartum hemorrhage (PPH) during cesarean delivery.

Methods: We analyzed perinatal outcomes comparing two periods, before (Group 1, Oxytocin era) and after (Group 2, Carbetocin era), when Carbetocin was implemented as a preventive method for PPH during cesarean delivery.

Results: Rates of PPH were significantly lower in Group 2 as compared with Group 1, as evidenced by lower requirements for blood transfusions (1% vs. 4.1%, p=0.003) and post-operative hemoglobin drop of ≥ 3g/dL (5.2% vs. 10.3%, p=0.008). The number of administered packed red blood cells (4 vs. 27 units, p=0.002), delta in hemoglobin level at discharge (1.3 ± 0.9 vs. 1.6 ± 1.2, p=0.002), and duration of hospitalization and re-admission rate were all significantly in favor of Carbetocin use. Financial benefit significantly favored using Carbetocin (ILS 112,237 vs. ILS 125,106.5, respectively, cost-difference of ILS 12,869.5).

Conclusions: Carbetocin has been shown to reduce rates of PPH and provide cost-effective benefits compared to the commonly used uterotonic Oxytocin.

Discussion: Carbetocin showed several advantages compared to Oxytocin in PPH prevention during cesarean section. The clinical and economic research evidence supports the routine implementation of Carbetocin administration to prevent PPH during cesarean delivery.

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