Use of carbetocin in elective caesarean sections

• Published in: European journal of hospital pharmacy. Science and practice Vol. 19; no. 2; p. 155
• Main Authors: Santana, V. Martínez, Sánchez, M.T. Sánchez, Parreño, S. Camacho
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.04.2012
• Subjects: Gynecology; Multiple births; Obstetrics; Risk factors
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2012-000074.185

Background The Pharmacy and Therapeutics Committee (PTC) decided to evaluate the use of carbetocin following a request by the Obstetrics and Gynaecology department. Purpose To evaluate the use of carbetocin in elective Caesareans. Materials and methods A retrospective, observational study was undertaken over 14 months (March 2010–April 2011). The following variables were recorded: date of request and date of Caesarean, age of patient, elective Caesarean or not, urgent or planned Caesarean and bleeding risk factors. Results During the period of study, 134 patients were treated, average age of 34 years (21–45). In 87.31% of the cases (117) carbetocin was used for an elective Caesarean and in 12.68% of the cases (17) for urgent Caesareans. Of the 117 elective Caesareans, 63.43% (72) were planned Caesareans, whereas 38.46% of these Caesareans (45) had no type of planning. 59.70% of the requests (80) included some bleeding risk factor as opposed to 40.29% of the requests (54) that undertook treatment without any risk factors. The bleeding risk factors involved in the use of carbetocin were: 27/129 multiple births, 21/129 previous uterine surgery, 3/129 premature sac breaking, 3/129 previous haemorrhage, 6/129 myomas, 4/129 multiparity, 5/129 macrosomia, 5/129 treatment with anticoagulants or thrombocytopenia and 1/129 polyhydramnios. In 5 cases the information was not available. Conclusions ▶Carbetocin was requested for 134 patients as opposed to the 180 proposed by the Service of Obstetrics and Gynaecology. ▶A standard form is required for prescribing carbetocin, which includes requesting the bleeding risk factors, in order to obtain information from the physicians. ▶Due to the complexity of the case histories, an evaluation of the efficacy of carbetocin needs the review of clinical histories as well as the analysis of the incidents of postcaesarean bleeding.