Risk Factors for Carbetocin Failure after a Cesarean Section: Is Obesity One of Them?
Obese pregnant women have increased rates of fetal macrosomia, long labor, and cesarean sections, which lead to an increased risk of postpartum hemorrhage (PPH). Carbetocin is useful for the prevention of PPH after a cesarean section. Our study aimed to investigate predictors of carbetocin failure a...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/17/3767 |
| _version_ | 1797521218430042112 |
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| author | Manon Degez Lucie Planche Agnès Dorion Alexis Duchalais Emelyne Lefizelier Guillaume Ducarme |
| author_facet | Manon Degez Lucie Planche Agnès Dorion Alexis Duchalais Emelyne Lefizelier Guillaume Ducarme |
| author_sort | Manon Degez |
| collection | DOAJ |
| description | Obese pregnant women have increased rates of fetal macrosomia, long labor, and cesarean sections, which lead to an increased risk of postpartum hemorrhage (PPH). Carbetocin is useful for the prevention of PPH after a cesarean section. Our study aimed to investigate predictors of carbetocin failure after a cesarean section, and specifically whether obesity is associated with carbetocin failure. We retrospectively analyzed all women who received carbetocin after a cesarean section. Carbetocin failure was defined as changes in hematocrit and hemoglobin, blood loss ≥ 1000 mL, and the need for an additional uterotonic agent or second-line therapies for persistent PPH. Univariate and multivariate analyses were performed to investigate predictors of carbetocin failure. The study included 600 women, with 131 (21.8%) obese women. Overall, 44 (7.3%) carbetocin failures were reported, and rates of obese women were similar between groups (carbetocin failure, 11.4% vs. 22.9%; <i>p</i> = 0.08). Previous PPH (<i>p</i> < 0.001), a cesarean section during labor (<i>p</i> = 0.01), cervical ripening (<i>p</i> = 0.02), and birthweight (<i>p</i> = 0.01) were significantly different between groups. In the multivariable logistic regression analysis adjusted for potential confounders, cervical ripening (adjusted odds ratio (OR) 2.23, 95% confidence interval (CI) 1.01–4.80), compared with spontaneous labor, was significantly associated with carbetocin failure. Obesity was not associated with carbetocin failure after cesarean sections. |
| first_indexed | 2024-03-10T08:09:29Z |
| format | Article |
| id | doaj.art-1a293d60dec94e4cb39616c0b8bc0dd5 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T08:09:29Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-1a293d60dec94e4cb39616c0b8bc0dd52023-11-22T10:47:08ZengMDPI AGJournal of Clinical Medicine2077-03832021-08-011017376710.3390/jcm10173767Risk Factors for Carbetocin Failure after a Cesarean Section: Is Obesity One of Them?Manon Degez0Lucie Planche1Agnès Dorion2Alexis Duchalais3Emelyne Lefizelier4Guillaume Ducarme5Department of Obstetrics and Gynecology, Centre Hospitalier Departemental, 85000 La Roche sur Yon, FranceClinical Research Center, Centre Hospitalier Departemental, 85000 La Roche sur Yon, FranceClinical Research Center, Centre Hospitalier Departemental, 85000 La Roche sur Yon, FranceDepartment of Anesthesiology, Centre Hospitalier Departemental, 85000 La Roche sur Yon, FranceDepartment of Obstetrics and Gynecology, Centre Hospitalier Departemental, 85000 La Roche sur Yon, FranceDepartment of Obstetrics and Gynecology, Centre Hospitalier Departemental, 85000 La Roche sur Yon, FranceObese pregnant women have increased rates of fetal macrosomia, long labor, and cesarean sections, which lead to an increased risk of postpartum hemorrhage (PPH). Carbetocin is useful for the prevention of PPH after a cesarean section. Our study aimed to investigate predictors of carbetocin failure after a cesarean section, and specifically whether obesity is associated with carbetocin failure. We retrospectively analyzed all women who received carbetocin after a cesarean section. Carbetocin failure was defined as changes in hematocrit and hemoglobin, blood loss ≥ 1000 mL, and the need for an additional uterotonic agent or second-line therapies for persistent PPH. Univariate and multivariate analyses were performed to investigate predictors of carbetocin failure. The study included 600 women, with 131 (21.8%) obese women. Overall, 44 (7.3%) carbetocin failures were reported, and rates of obese women were similar between groups (carbetocin failure, 11.4% vs. 22.9%; <i>p</i> = 0.08). Previous PPH (<i>p</i> < 0.001), a cesarean section during labor (<i>p</i> = 0.01), cervical ripening (<i>p</i> = 0.02), and birthweight (<i>p</i> = 0.01) were significantly different between groups. In the multivariable logistic regression analysis adjusted for potential confounders, cervical ripening (adjusted odds ratio (OR) 2.23, 95% confidence interval (CI) 1.01–4.80), compared with spontaneous labor, was significantly associated with carbetocin failure. Obesity was not associated with carbetocin failure after cesarean sections.https://www.mdpi.com/2077-0383/10/17/3767carbetocinfailureobesitypostpartum hemorrhageprevention |
| spellingShingle | Manon Degez Lucie Planche Agnès Dorion Alexis Duchalais Emelyne Lefizelier Guillaume Ducarme Risk Factors for Carbetocin Failure after a Cesarean Section: Is Obesity One of Them? Journal of Clinical Medicine carbetocin failure obesity postpartum hemorrhage prevention |
| title | Risk Factors for Carbetocin Failure after a Cesarean Section: Is Obesity One of Them? |
| title_full | Risk Factors for Carbetocin Failure after a Cesarean Section: Is Obesity One of Them? |
| title_fullStr | Risk Factors for Carbetocin Failure after a Cesarean Section: Is Obesity One of Them? |
| title_full_unstemmed | Risk Factors for Carbetocin Failure after a Cesarean Section: Is Obesity One of Them? |
| title_short | Risk Factors for Carbetocin Failure after a Cesarean Section: Is Obesity One of Them? |
| title_sort | risk factors for carbetocin failure after a cesarean section is obesity one of them |
| topic | carbetocin failure obesity postpartum hemorrhage prevention |
| url | https://www.mdpi.com/2077-0383/10/17/3767 |
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