Yıl: 2023 Cilt: 61 Sayı: 1 Sayfa Aralığı: 8 - 14 Metin Dili: İngilizce İndeks Tarihi: 07-06-2023

Comparison of the Renal Effects of Carbetoxin and Oxytocin in Hemorrhage Prophylaxis in Elective Cesarean Delivery

Öz:
Objective: The hemodynamic effects and the renal outcome of patients undergoing elective cesarian section with Oxytocin and carbetocin for postpartum haemorrhage prophylaxis are evaluated. Methods: One hundred patients without risk factors for postpartum haemorrhage undergoing elective cesarean delivery, under spinal anaesthesia, were randomly allocated to receive either a single dose of carbetocin (100μg/3 mL) (n = 50) or Oxytocin intravenous injection (3 IU/3 mL) (n=50). The primary outcome was blood loss and hemodynamic effects. The secondary parameter evaluated was the renal effects of drugs. Results: Regarding the hemodynamic effects, intraoperative (243±116.91 ml vs 311.30±130.23 ml, p=0.002) and second-hour postoperative blood loss (24.72 ± 9.43 ml vs 35.54 ± 19.4 ml, p=0.003) were significantly lower in the carbetocin group. At two hours postoperatively, urine osmolality (322.66±211.67 vs 401.45±218.08, p=0.028) was significantly higher in the oxytocin group. Conversely, postoperative urine sodium was higher in the carbetocin group at the twenty four hours in the carbetocin group (51.90±36.74 vs 42.42±41.63, p = 0.004). Conclusion: Carbetocin is easy to use with lower blood loss and less requirement of additional uterotonics compared to Oxytocin. Both drugs cause minimal changes in renal parameters at physiological limits. The renal effects might be far more different with higher doses of both drugs that necessitate further research.
Anahtar Kelime:

Elektif Sezaryen Doğumlarda Hemoraji Profilaksisinde Karbetoksin ve Oksitosinin Renal Etkilerinin Karşılaştırılması

Öz:
Amaç: Doğum sonu kanama profilaksisi için Oksitosin ve karbetosin ile elektif sezaryen uygulanan hastaların hemodinamik etkileri ve böbrek sonuçları değerlendirilmektedir. Metot: Spinal anestezi altında elektif sezaryenle doğum yapan doğum sonu kanama için risk faktörü olmayan yüz gebe, tek doz karbetosin (100μg/3 mL) (n=50) veya intravenöz Oksitosin enjeksiyonu (3 IU/ 3 mL) (n=50). Birincil sonuç, kan kaybı ve hemodinamik etkilerdi. Değerlendirilen ikincil parametre ilaçların renal etkileriydi. Bulgular: Hemodinamik etkiler açısından, intraoperatif (243±116,91 ml - 311,30±130,23 ml, p=0,002) ve ameliyat sonrası ikinci saat kan kaybı (24,72 ± 9,43 ml - 35,54 ± 19,4 ml, p=0,003) karbetoksin grubunda kadınlarda anlamlı olarak daha düşüktü. Ameliyattan iki saat sonra, oksitosin grubunda idrar ozmolalitesi (322.66±211.67'ye karşılık 401.45±218.08, p=0.028) anlamlı olarak daha yüksekti. Tersine, ameliyat sonrası idrar sodyumu karbetosin grubunda yirmi dört saatte karbetosin grubunda daha yüksekti (51.90±36.74'e karşı 42.42±41.63, p = 0.004). Sonuç: Karbetosin Oksitosine göre daha düşük kan kaybı ve daha az ek uterotonik gereksinimi ile kullanımı kolaydır. Her iki ilaç da fizyolojik sınırlarda renal parametrelerde minimal değişikliklere neden olur. Böbrek etkileri, daha fazla araştırma gerektiren her iki ilacın daha yüksek dozları ile çok daha farklı olabilir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. American College of Obstetricians and Gynecologists. Clinical management guidelines for obstetrician-gynecologists: postpartum hemorrhage. ACOG Practice bulletin no. 76. Obstet Gynecol 2006;108:1039-47.
  • 2. World Health Organization. WHO recommendations for the prevention and treatment of postpartum haemorrhage. Geneva:World Health Organization. 2012. WHO Guidelines Approved by the Guidelines Review Committee. Available at: http://www.who.int/reproductivehealth/publi cations/maternal_perinatal_health/97892415 48502/en/. Accessed Nov. 1, 2013.
  • 3. Jansen A.J., van Rhenen DJ, Steegers E.A.P., et al. Postpartum hemorrhage and transfusion of blood and blood components. Obstetrical & gynecological survey, 2005. 60(10): p. 663-671.
  • 4. Combs CA, Murphy EL, Laros Jr R.K. Factors associated with postpartum hemorrhage with vaginal birth. Obstetrics and gynecology, 1991. 77(1): p. 69-76.
  • 5. Begley CM, Guilliland K, Dixon L, et al. Irish and New Zealand midwives' expertise in expectant management of the third stage of labour: the 'MEET'study. Midwifery. 2012 Dec;28(6):733-9.
  • 6. Tunçalp O, Souza JP, Gülmezoglu M, et al. New WHO recommendations on prevention and treatment of postpartum hemorrhage. Int J Gynaecol Obstet 2013;123:254e6.
  • 7. Anderson JM, Etches D. Prevention and management of postpartum hemorrhage. Am Fam Physician 2007;75:875e82.
  • 8. Brindley BA, Sokol RJ. Induction and augmentation of labor: basis and methods for current practice. Obstet Gynecol Surv 1988;43:730e43.
  • 9. Leduc D, Senikas V, Lalonde AB, et al. Active management of the third stage of labour: prevention and treatment of postpartum hemorrhage. J Obstet Gynaecol Can 2009;31:980e93.
  • 10. Pinder AJ, Dresner M, Calow C, et al. Haemodynamic changes caused by Oxytocin during caesarean delivery under spinal anaesthesia. Int J Obstet Anesth 2002;11:156–9.
  • 11. Thomas JS, Koh SH, Cooper GM. Haemodynamic effects of Oxytocin given as i.v. bolus or infusion on women undergoing Caesarean delivery. Br J Anaesth 2007;98:116–9.
  • 12. Svanstro¨m MC, Biber B, Hanes M, et al. Signs of myocardial ischaemia after injection of Oxytocin: a randomized double-blind comparison of Oxytocin and methylergometrineduring Caesarean section. Br J Anaesth 2008;100:683–9.
  • 13. Chong YS, Su LL, Arulkumaran S. Current strategies for the prevention of postpartum haemorrhage in the third stage of labour. Current Opinion in Obstetrics and Gynaecology 2003; 16(2):143–50.
  • 14. Sweeney G, Holbrook AM, Levine M, et al. Pharmacokinetics of carbetocin, a long acting oxytocin analogue, in nonpregnant women. Curr TherRes 1990; 47:528-540,
  • 15. Hunter DJ, Schulz P, Wassenaar W. Effect of carbetocin, a long-acting oxytocin analog on the postpartum uterus. Clinical Pharmacology and Therapeutics 1992;52:60–7.
  • 16. El Behery MM, El Sayed GA, El Hameed A.A., et al. Carbetocin versus Oxytocin for prevention of postpartum hemorrhage in obese nulliparous women undergoing emergency cesarean delivery. J Matern Fetal Neonatal Med 2016;29:1257e60
  • 17. Chou CL, DiGiovanni SR, Luther A, et al. Oxytocin as an antidiuretic hormone: II, role of V2 vasopressin receptor. Am J Physiol 269: F78–F85, 1995.
  • 18. Pouzet B, Serradeil-Le GC, Bouby N, et al. Selective blockade of vasopressin V2 receptors reveals significant V2-mediated water reabsorption in Brattleboro rats with diabetes insipidus. Nephrol Dial Transplant 16: 725–734, 2001.
  • 19. Lyness J, Robinson AG, Sheridan MN, et al. Antidiuretic effects of Oxytocin in the Brattleboro rat. Experientia 41: 1444–1446, 1985
  • 20. Potter, R.R., Water retention due to Oxytocin. Obstetrics & Gynecology, 1964. 23(5): p. 699-702.
  • 21. Engstrom T, Barth T, Melin P, et al. Oxytocin receptor binding and uterotonic activity of carbetocin and its metabolites following enzymatic degradation. Eur J Pharmacol. 1998 Aug 21;355(2-3):203-10.
  • 22. A J Butwick, L Coleman, S E Cohen, E T Riley, B Carvalho. Minimum effective bolus dose of Oxytocin during elective Caesarean delivery. Br J Anaesth . 2010 Mar;104(3):338-43. doi: 10.1093/bja/aeq004.
  • 23. Su LL, Chong YS, Samuel M. Carbetocin for preventing postpartum haemorrhage. Cochrane Database Syst Rev. 2012 Feb 15;(2):CD005457.
  • 24. Voon HY, Suharjono HN, Shafie AA, et al. Carbetocin versus Oxytocin for the prevention of postpartum hemorrhage: A meta-analysis of randomized controlled trials in cesarean deliveries. Taiwan J Obstet Gynecol. 2018 Jun;57(3):332-339.
  • 25. Borruto F, Treisser A, Comparetto C. Utilization of carbetocin for prevention of postpartum hemorrhage after cesarean section: a randomized clinical trial. Arch Gynecol Obstet. 2009 Nov;280(5):707-12.
  • 26. Baribeau DA, Anagnostou E. Oxytocin and vasopressin: linking pituitary neuropeptides and their receptors to social neurocircuitsFront Neurosci. 2015; 9: 335.
  • 27. Knepper MA. Molecular physiology of urinary concentrating mechanism: regulation of aquaporin water channels by vasopressin. Am J Physiol. 1997 Jan;272(1 Pt 2):F3-12.
APA ŞAHİN Ö, YILMAZ H, ARSLANCA T, Kazbek B, ekmekçi p, caglar g (2023). Comparison of the Renal Effects of Carbetoxin and Oxytocin in Hemorrhage Prophylaxis in Elective Cesarean Delivery. , 8 - 14.
Chicago ŞAHİN Özgür,YILMAZ HAKAN,ARSLANCA Tufan,Kazbek Baturay Kansu,ekmekçi perihan,caglar gamze sinem Comparison of the Renal Effects of Carbetoxin and Oxytocin in Hemorrhage Prophylaxis in Elective Cesarean Delivery. (2023): 8 - 14.
MLA ŞAHİN Özgür,YILMAZ HAKAN,ARSLANCA Tufan,Kazbek Baturay Kansu,ekmekçi perihan,caglar gamze sinem Comparison of the Renal Effects of Carbetoxin and Oxytocin in Hemorrhage Prophylaxis in Elective Cesarean Delivery. , 2023, ss.8 - 14.
AMA ŞAHİN Ö,YILMAZ H,ARSLANCA T,Kazbek B,ekmekçi p,caglar g Comparison of the Renal Effects of Carbetoxin and Oxytocin in Hemorrhage Prophylaxis in Elective Cesarean Delivery. . 2023; 8 - 14.
Vancouver ŞAHİN Ö,YILMAZ H,ARSLANCA T,Kazbek B,ekmekçi p,caglar g Comparison of the Renal Effects of Carbetoxin and Oxytocin in Hemorrhage Prophylaxis in Elective Cesarean Delivery. . 2023; 8 - 14.
IEEE ŞAHİN Ö,YILMAZ H,ARSLANCA T,Kazbek B,ekmekçi p,caglar g "Comparison of the Renal Effects of Carbetoxin and Oxytocin in Hemorrhage Prophylaxis in Elective Cesarean Delivery." , ss.8 - 14, 2023.
ISNAD ŞAHİN, Özgür vd. "Comparison of the Renal Effects of Carbetoxin and Oxytocin in Hemorrhage Prophylaxis in Elective Cesarean Delivery". (2023), 8-14.
APA ŞAHİN Ö, YILMAZ H, ARSLANCA T, Kazbek B, ekmekçi p, caglar g (2023). Comparison of the Renal Effects of Carbetoxin and Oxytocin in Hemorrhage Prophylaxis in Elective Cesarean Delivery. Ege Klinikleri Tıp Dergisi, 61(1), 8 - 14.
Chicago ŞAHİN Özgür,YILMAZ HAKAN,ARSLANCA Tufan,Kazbek Baturay Kansu,ekmekçi perihan,caglar gamze sinem Comparison of the Renal Effects of Carbetoxin and Oxytocin in Hemorrhage Prophylaxis in Elective Cesarean Delivery. Ege Klinikleri Tıp Dergisi 61, no.1 (2023): 8 - 14.
MLA ŞAHİN Özgür,YILMAZ HAKAN,ARSLANCA Tufan,Kazbek Baturay Kansu,ekmekçi perihan,caglar gamze sinem Comparison of the Renal Effects of Carbetoxin and Oxytocin in Hemorrhage Prophylaxis in Elective Cesarean Delivery. Ege Klinikleri Tıp Dergisi, vol.61, no.1, 2023, ss.8 - 14.
AMA ŞAHİN Ö,YILMAZ H,ARSLANCA T,Kazbek B,ekmekçi p,caglar g Comparison of the Renal Effects of Carbetoxin and Oxytocin in Hemorrhage Prophylaxis in Elective Cesarean Delivery. Ege Klinikleri Tıp Dergisi. 2023; 61(1): 8 - 14.
Vancouver ŞAHİN Ö,YILMAZ H,ARSLANCA T,Kazbek B,ekmekçi p,caglar g Comparison of the Renal Effects of Carbetoxin and Oxytocin in Hemorrhage Prophylaxis in Elective Cesarean Delivery. Ege Klinikleri Tıp Dergisi. 2023; 61(1): 8 - 14.
IEEE ŞAHİN Ö,YILMAZ H,ARSLANCA T,Kazbek B,ekmekçi p,caglar g "Comparison of the Renal Effects of Carbetoxin and Oxytocin in Hemorrhage Prophylaxis in Elective Cesarean Delivery." Ege Klinikleri Tıp Dergisi, 61, ss.8 - 14, 2023.
ISNAD ŞAHİN, Özgür vd. "Comparison of the Renal Effects of Carbetoxin and Oxytocin in Hemorrhage Prophylaxis in Elective Cesarean Delivery". Ege Klinikleri Tıp Dergisi 61/1 (2023), 8-14.