Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2012 Apr 18;2012(4):CD005457.
doi: 10.1002/14651858.CD005457.pub4.

Carbetocin for preventing postpartum haemorrhage

Lin-Lin Su  1 , Yap-Seng Chong, Miny Samuel
Affiliations
Meta-Analysis

Carbetocin for preventing postpartum haemorrhage

Lin-Lin Su et al. Cochrane Database Syst Rev. .

Abstract

Background: Postpartum haemorrhage (PPH) is one of the major contributors to maternal mortality and morbidity worldwide. Active management of the third stage of labour has been proven to be effective in the prevention of PPH. Syntometrine is more effective than oxytocin but is associated with more side effects. Carbetocin, a long-acting oxytocin agonist, appears to be a promising agent for the prevention of PPH.

Objectives: To determine if the use of oxytocin agonist is as effective as conventional uterotonic agents for the prevention of PPH, and assess the best routes of administration and optimal doses of oxytocin agonist.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (1 March 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1 of 4), MEDLINE (1966 to 1 March 2011) and EMBASE (1974 to 1 March 2011). We checked references of articles and communicated with authors and pharmaceutical industry contacts.

Selection criteria: Randomised controlled trials which compared oxytocin agonist (carbetocin) with other uterotonic agents or with placebo or no treatment for the prevention of PPH.

Data collection and analysis: Two review authors independently assessed trials for inclusion, assessed risk of bias and extracted data.

Main results: We included 11 studies (2635 women) in the review. Six trials compared carbetocin with oxytocin; four of these were conducted for women undergoing caesarean deliveries, one was for women following vaginal deliveries and one did not state the mode of delivery clearly. The carbetocin was administered as 100 µg intravenous dosage across the trials, while oxytocin was administered intravenously but at varied dosages. Four trials compared intramuscular carbetocin and intramuscular syntometrine for women undergoing vaginal deliveries. Three of the trials were on women with no risk factor for PPH, while one trial was on women with risk factors for PPH. One trial compared the use of intravenous carbetocin with placebo. Use of carbetocin resulted in a statistically significant reduction in the need for therapeutic uterotonics (risk ratio (RR) 0.62; 95% confidence interval (CI) 0.44 to 0.88; four trials, 1173 women) compared to oxytocin for those who underwent caesarean section, but not for vaginal delivery. Compared to oxytocin, carbetocin was associated with a reduced need for uterine massage following both caesarean delivery (RR 0.54; 95% CI 0.37 to 0.79; two trials, 739 women) and vaginal delivery (RR 0.70; 95% CI 0.51 to 0.94; one trial, 160 women). There were no statistically significant differences between carbetocin and oxytocin in terms of risk of any PPH (blood loss greater than 500 ml) or in risk of severe PPH (blood loss greater than 1000 ml). Comparison between carbetocin and syntometrine showed a lower mean blood loss in women who received carbetocin compared to syntometrine (mean difference (MD) -48.84 ml; 95% CI -94.82 to -2.85; four trials, 1030 women). There was no statistically significant difference in terms of the need for therapeutic uterotonic agents, but the risk of adverse effects such as nausea and vomiting were significantly lower in the carbetocin group: nausea (RR 0.24; 95% CI 0.15 to 0.40; four trials, 1030 women); vomiting (RR 0.21; 95% CI 0.11 to 0.39; four trials, 1030 women). The incidence of postpartum hypertension was also significantly lower in women who received carbetocin compared to those who received syntometrine. Cost-effectiveness of carbetocin was investigated by one study published as an abstract, with limited data.

Authors' conclusions: For women who undergo caesarean section, carbetocin resulted in a statistically significant reduction in the need for therapeutic uterotonics compared to oxytocin, but there is no difference in the incidence of postpartum haemorrhage. Carbetocin is associated with less blood loss compared to syntometrine in the prevention of PPH for women who have vaginal deliveries and is associated with significantly fewer adverse effects. Further research is needed to analyse the cost-effectiveness of carbetocin as a uterotonic agent.

PubMed Disclaimer

Conflict of interest statement

For the Su 2009 trial conducted by Su LL and Chong YS, the carbetocin was purchased from Ferring Inc at a discounted price. All decisions relating to the inclusion of the trial in this review, assessment of risk of bias and data extraction were carried out by the other review author (Miny Samuel) who was not directly involved in the trial.

Figures

1.1
1.1. Analysis
Comparison 1 Carbetocin versus oxytocin, Outcome 1 Severe postpartum haemorrhage (> 1000 ml).
1.2
1.2. Analysis
Comparison 1 Carbetocin versus oxytocin, Outcome 2 Postpartum haemorrhage (> 500 ml or as defined by trialist).
1.3
1.3. Analysis
Comparison 1 Carbetocin versus oxytocin, Outcome 3 Use of additional uterotonic therapy.
1.4
1.4. Analysis
Comparison 1 Carbetocin versus oxytocin, Outcome 4 Need for blood transfusion.
1.5
1.5. Analysis
Comparison 1 Carbetocin versus oxytocin, Outcome 5 Mean blood loss (millilitres).
1.6
1.6. Analysis
Comparison 1 Carbetocin versus oxytocin, Outcome 6 Mean haemoglobin difference (g/dL).
1.7
1.7. Analysis
Comparison 1 Carbetocin versus oxytocin, Outcome 7 Mean haematocrit difference (g/L).
1.8
1.8. Analysis
Comparison 1 Carbetocin versus oxytocin, Outcome 8 Need for uterine massage (not prespecified).
1.9
1.9. Analysis
Comparison 1 Carbetocin versus oxytocin, Outcome 9 Maternal adverse drug reactions for caesarean delivery.
1.10
1.10. Analysis
Comparison 1 Carbetocin versus oxytocin, Outcome 10 Maternal adverse drug reactions for vaginal delivery.
1.11
1.11. Analysis
Comparison 1 Carbetocin versus oxytocin, Outcome 11 Headache in caesarean/vaginal delivery.
1.12
1.12. Analysis
Comparison 1 Carbetocin versus oxytocin, Outcome 12 Nausea for caesarean/vaginal delivery.
1.13
1.13. Analysis
Comparison 1 Carbetocin versus oxytocin, Outcome 13 Vomiting for caesarean/vaginal delivery.
1.14
1.14. Analysis
Comparison 1 Carbetocin versus oxytocin, Outcome 14 Tremor for caesarean/vaginal delivery.
1.15
1.15. Analysis
Comparison 1 Carbetocin versus oxytocin, Outcome 15 Chills in caesarean/vaginal delivery.
1.16
1.16. Analysis
Comparison 1 Carbetocin versus oxytocin, Outcome 16 At least one adverse event.
2.1
2.1. Analysis
Comparison 2 Carbetocin versus syntometrine, Outcome 1 Severe postpartum haemorrhage (> 1000 ml).
2.2
2.2. Analysis
Comparison 2 Carbetocin versus syntometrine, Outcome 2 Postpartum haemorrhage (> 500 ml).
2.3
2.3. Analysis
Comparison 2 Carbetocin versus syntometrine, Outcome 3 Use of additional uterotonic therapy.
2.4
2.4. Analysis
Comparison 2 Carbetocin versus syntometrine, Outcome 4 Need for blood transfusion.
2.5
2.5. Analysis
Comparison 2 Carbetocin versus syntometrine, Outcome 5 Mean blood loss (millimetres).
2.6
2.6. Analysis
Comparison 2 Carbetocin versus syntometrine, Outcome 6 Vomiting.
2.7
2.7. Analysis
Comparison 2 Carbetocin versus syntometrine, Outcome 7 Nausea.
2.8
2.8. Analysis
Comparison 2 Carbetocin versus syntometrine, Outcome 8 Tremor.
2.9
2.9. Analysis
Comparison 2 Carbetocin versus syntometrine, Outcome 9 Retching.
2.10
2.10. Analysis
Comparison 2 Carbetocin versus syntometrine, Outcome 10 Headache.
2.11
2.11. Analysis
Comparison 2 Carbetocin versus syntometrine, Outcome 11 Sweating.
2.12
2.12. Analysis
Comparison 2 Carbetocin versus syntometrine, Outcome 12 Uterine or abdominal pain.
2.13
2.13. Analysis
Comparison 2 Carbetocin versus syntometrine, Outcome 13 Facial flushing.
2.14
2.14. Analysis
Comparison 2 Carbetocin versus syntometrine, Outcome 14 Shivering.
2.15
2.15. Analysis
Comparison 2 Carbetocin versus syntometrine, Outcome 15 Mean haemoglobin difference (g/dL).
2.16
2.16. Analysis
Comparison 2 Carbetocin versus syntometrine, Outcome 16 Hypertension (blood pressure greater than or equal to 140/90) immediately after delivery.
2.17
2.17. Analysis
Comparison 2 Carbetocin versus syntometrine, Outcome 17 Hypertension (blood pressure greater than or equal to 140/90) 30 minutes after delivery.
2.18
2.18. Analysis
Comparison 2 Carbetocin versus syntometrine, Outcome 18 Hypertension (blood pressure greater than or equal to 140/90) 60 minutes after delivery.
3.1
3.1. Analysis
Comparison 3 Carbetocin versus syntometrine, Outcome 1 Severe postpartum haemorrhage (> 1000ml).
3.2
3.2. Analysis
Comparison 3 Carbetocin versus syntometrine, Outcome 2 Postpartum haemorrhage (> 500 ml).
3.3
3.3. Analysis
Comparison 3 Carbetocin versus syntometrine, Outcome 3 Use of additional uterotonic therapy.
3.4
3.4. Analysis
Comparison 3 Carbetocin versus syntometrine, Outcome 4 Need for blood transfusion.
3.5
3.5. Analysis
Comparison 3 Carbetocin versus syntometrine, Outcome 5 Mean blood loss (millimetres).
3.6
3.6. Analysis
Comparison 3 Carbetocin versus syntometrine, Outcome 6 Vomiting.
3.7
3.7. Analysis
Comparison 3 Carbetocin versus syntometrine, Outcome 7 Nausea.
3.8
3.8. Analysis
Comparison 3 Carbetocin versus syntometrine, Outcome 8 Tremor.
3.9
3.9. Analysis
Comparison 3 Carbetocin versus syntometrine, Outcome 9 Retching.
3.10
3.10. Analysis
Comparison 3 Carbetocin versus syntometrine, Outcome 10 Headache.
3.11
3.11. Analysis
Comparison 3 Carbetocin versus syntometrine, Outcome 11 Sweating.
3.12
3.12. Analysis
Comparison 3 Carbetocin versus syntometrine, Outcome 12 Uterine or abdominal pain.
3.13
3.13. Analysis
Comparison 3 Carbetocin versus syntometrine, Outcome 13 Facial flushing.
3.14
3.14. Analysis
Comparison 3 Carbetocin versus syntometrine, Outcome 14 Shivering.
3.15
3.15. Analysis
Comparison 3 Carbetocin versus syntometrine, Outcome 15 Mean haemoglobin difference (g/dL).
3.16
3.16. Analysis
Comparison 3 Carbetocin versus syntometrine, Outcome 16 Hypertension (blood pressure greater than or equal to 140/90 mmHg) immediately after delivery.
3.17
3.17. Analysis
Comparison 3 Carbetocin versus syntometrine, Outcome 17 Hypertension (blood pressure greater than or equal to 140/90) 30 minutes after delivery.
3.18
3.18. Analysis
Comparison 3 Carbetocin versus syntometrine, Outcome 18 Hypertension (blood pressure greater than or equal to 140/90) 60 minutes after delivery.
4.1
4.1. Analysis
Comparison 4 Carbetocin versus placebo, Outcome 1 Use of additional uterotonic therapy.
See this image and copyright information in PMC

Update of

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

Askar 2011 {published data only}
    1. Askar AA, Ismail MT, El‐Ezz AA, Rabie NH. Carbetocin versus syntometrine in the management of third stage of labor following vaginal delivery. Archives of Gynecology and Obstetrics 2011;284(6):1359‐65. - PubMed
Attilakos 2010 {published data only}
    1. Attilakos G, Psaroudakis D, Ash J, Buchanan R, Winter C, Donald F, et al. Can a new oxytocin analogue reduce the need for additional oxytocics after caesarean section? The results of a double‐blind randomised trial. Archives of Disease in Childhood. Fetal and Neonatal Edition 2008;93(Suppl 1):Fa51.
    1. Attilakos G, Psaroudakis D, Ash J, Buchanan R, Winter C, Donald F, et al. Carbetocin versus oxytocin for the prevention of postpartum haemorrhage following caesarean section: the results of a double‐blind randomised trial. BJOG: an international journal of obstetrics and gynaecology 2010;117(8):929‐36. - PubMed
    1. Attilakos G, Psaroudakis D, Ash J, Buchanan R, Winter C, Donald F, et al. The haemodynamic effects of oxytocin and carbetocin following caesarean section: the results of a double‐blind randomised study. BJOG: an international journal of obstetrics and gynaecology 2008;115(s1):140‐1. - PubMed
    1. Attilakos G, Psaroudakis D, Ash J, Buchanen R, Winter C, Draycott T. Low recruitment rate for a drug trial in obstetrics: an effect of the publicity following the TGN1412 clinical trial at the PAREXEL Research Unit in Northwick Park Hospital? [abstract]. 31st British International Congress of Obstetrics and Gynaecology; 2007 July 4‐6; London, UK. 2007:110.
Barton 1996 {published data only}
    1. Barton SR, Jackson A. The safety and efficiency of carbetocin to control uterine bleeding following caesarean section. Prenatal and Neonatal Medicine 1996;1(1):185.
Borruto 2009 {published data only}
    1. Borruto F, Treisser A, Comparetto C. Utilization of carbetocin for prevention of postpartum hemorrhage after cesarean section: a randomized clinical trial. Archives of Gynecology and Obstetrics 2009;280(5):707‐12. - PubMed
Boucher 1998 {published data only}
    1. Boucher M, Horbay GL, Griffin P, Deschamps Y, Desjardins C, Schulz M, et al. Double‐blind, randomized comparison of the effect of carbetocin and oxytocin on intraoperative blood loss and uterine tone of patients undergoing caesarean section. Journal of Perinatology 1998;18(3):202‐7. - PubMed
Boucher 2004 {published data only}
    1. Boucher M. Carbetocin IM injection vs oxytocin IV infusion for prevention of postpartum haemorrhage in women at risk following vaginal delivery. Journal of Obstetrics & Gynaecology Canada: JOGC 2003;25 Suppl:S15.
    1. Boucher M, Nimrod C, Tawagi G. Carbetocin IM injection vs oxytocin IV infusion for prevention of postpartum haemorrhage in women at risk following vaginal delivery. American Journal of Obstetrics and Gynaecology 2001;185(6 Pt 2):A494.
    1. Boucher M, Nimrod CA, Tawagi GF, Meeker TA, Rennicks White RE, Varin, J. Comparison of carbetocin and oxytocin for the prevention of postpartum haemorrhage following vaginal delivery: a double‐blind randomized trial. Journal of Obstetrics & Gynaecology Canada: JOGC 2004;26(5):481‐8. - PubMed
Dansereau 1999 {published data only}
    1. Dansereau J, Gambling D, Joshi A, Helewa M, Doran T, Lange E, et al. Double‐blind comparison of carbetocin vs oxytocin in preventing uterine atony post cesarean section. International Journal of Gynecology & Obstetrics 1994;46 Suppl:77.
    1. Dansereau J, Joshi AK, Helewa ME, Doran TA, Lange IR, Luther ER, et al. Comparison of carbetocin vs. oxytocin in prevention of uterine atony post cesarean section. Prenatal and Neonatal Medicine 1996;1(Suppl 1):80.
    1. Dansereau J, Joshi AK, Helewa ME, Doran TA, Lange IR, Luther ER, et al. Double‐blind comparison of carbetocin versus oxytocin in preventing uterine atony post cesarean section. European Journal of Obstetrics & Gynecology and Reproductive Biology 1996;69:37. - PubMed
    1. Dansereau J, Joshi AK, Helewa ME, Doran TA, Lange IR, Luther ER, et al. Double‐blind comparison of carbetocin versus oxytocin in prevention of uterine atony after caesarean section. American Journal of Obstetrics and Gynaecology 1999;180(3 Pt 1):670‐6. - PubMed
    1. Gambling D, Dansereau J, Schulz M, Horbay GLA, Waasenaar W. Double‐blind, randomized comparison of a single dose of carbetocin vs 8 hours oxytocin infusion after cesarean delivery: safety data. A Canadian multi‐center trial. International Journal of Obstetric Anesthesia 1994;3:113‐4.
Del Angel‐Garcia 2006 {published data only}
    1. Angel‐Garcia G, Garcia‐Contreras F, Constantino‐Casas P, Nevarez‐Sida A, Lopez‐Gonzalez N, Garcia‐Constantino M, et al. Economic evaluation of carbetocin for the prevention of uterine atony in patients with risk factors in Mexico. Value in Health 2006;9(6):A254.
Leung 2006 {published data only}
    1. Leung SW, Ng PS, Wong WY, Cheung TH. A randomised trial of carbetocin versus syntometrine in the management of the third stage of labour. BJOG: an international journal of obstetrics and gynaecology 2006;113:1459‐64. - PMC - PubMed
Nirmala 2009 {published data only}
    1. Nirmala K, Zainuddin AA, Ghani NA, Zulkifli S, Jamil MA. Carbetocin versus syntometrine in prevention of post‐partum hemorrhage following vaginal delivery. Journal of Obstetrics and Gynaecology Research 2009;35(1):48‐54. - PubMed
Su 2009 {published data only}
    1. Su LL, Rauff M, Chan YH, Mohamad Suphan N, Lau TP, Biswas A, et al. Carbetocin versus syntometrine for the third stage of labour following vaginal delivery‐‐a double‐blind randomised controlled trial. BJOG: an international journal of obstetrics and gynaecology 2009;116(11):1461‐6. - PubMed

References to ongoing studies

Gomez 2011 {published data only}
    1. Gomez MCG. Comparison of the effectiveness of carbetocin vs oxytocin in managing the third stage of labor in a group of women with risk factors for postpartum hemorrhage. Australian New Zealand Clinical Trials Registry (www.anzctr.org.au) (accessed 16 February 2011).
Kalahroudi 2010 {published data only}
    1. Kalahroudi MA. Comparison effect of carbetocine and syntometrin in prevention of post partum hemorrhage. IRCT Iranian Registry of Clinical Trials (www.irct.ir) (accessed 6 December 2010).

Additional references

Begley 2010
    1. Begley CM, Gyte GML, Murphy DJ, Devane D, McDonald SJ, McGuire W. Active versus expectant management for women in the third stage of labour. Cochrane Database of Systematic Reviews 2010, Issue 7. [DOI: 10.1002/14651858.CD007412] - DOI - PubMed
Cantwell 2011
    1. Cantwell R, Clutton‐Brock T, Cooper G, Dawson A, Drife J, Garrod D, et al. Saving mothers' lives: reviewing maternal deaths to make motherhood safer: 2006‐2008. The eighth report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. BJOG: an international journal of obstetrics and gynaecology 2011;118(Suppl 1):1‐203. - PubMed
Carey 1993
    1. Carey M. Adverse cardiovascular sequelae of ergometrine. British Journal of Obstetrics and Gynaecology 1993;100:865. - PubMed
Carroli 2008
    1. Carroli G, Cuesta C, Abalos E, Glumezoglu AM. Epidemiology of postpartum haemorrhage: a systematic review. Best Practice and Research. Clinical Obstetrics and Gynaecology 2008;22:999‐1012. - PubMed
Chong 2003
    1. 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. - PubMed
Chong 2006
    1. Chong YS, Su LL. Misoprostol for preventing PPH: some lessons learned. Lancet 2006;368:1216‐7. - PubMed
Cotter 2001
    1. Cotter AM, Ness A, Tolosa JE. Prophylactic oxytocin for the third stage of labour. Cochrane Database of Systematic Reviews 2001, Issue 4. [DOI: 10.1002/14651858.CD001808] - DOI - PubMed
Dumoulin 1981
    1. Dumoulin JG. A reappraisal of the use of ergometrine. Journal of Obstetrics and Gynaecology 1981;1:178‐81.
Egger 1997
    1. Egger M, Smith GD, Schneider M, Minder C. Bias in meta‐analysis detected by a simple, graphical test. BMJ 1997;315:629‐34. - PMC - PubMed
Etuk 1997
    1. Etuk SJ, Asuquo EE. Maternal mortality following post‐partum haemorrhage in Calabar: a 6‐year review. West African Journal of Medicine 1997;16:165‐9. - PubMed
Gulmezoglu 2011
    1. Gülmezoglu AM, Forna F, Villar J, Hofmeyr GJ. Prostaglandins for preventing postpartum haemorrhage. Cochrane Database of Systematic Reviews 2011, Issue 2. [DOI: 10.1002/14651858.CD000494.pub3] - DOI - PubMed
Harbord 2006
    1. Harbord RM, Egger M, Sterne JA. A modified test for small‐study effects in meta‐analyses of controlled trials with binary endpoints. Statistics in Medicine 2006;25:3443‐57. - PubMed
Higgins 2005a
    1. Higgins JPT, Green S, editors. Assessment of study quality. Cochrane Handbook for Systematic Reviews of interventions 4.2.5 [updated May 2005]; Section 6. In: The Cochrane Library, Issue 3, 2005. Chichester, UK: John Wiley & Sons, Ltd.
Higgins 2005b
    1. Higgins JPT, Green S, editors. Collecting data. Cochrane Handbook for Systematic Reviews of interventions 4.2.5 [updated May 2005]; Section 7. In: The Cochrane Library, Issue 3, 2005. Chichester, UK: John Wiley & Sons, Ltd.
Higgins 2011
    1. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Hofmeyr 2008
    1. Hofmeyr GJ, Abdel‐Aleem H, Abdel‐Aleem MA. Uterine massage for preventing postpartum haemorrhage. Cochrane Database of Systematic Reviews 2008, Issue 3. [DOI: 10.1002/14651858.CD006431.pub2] - DOI - PubMed
Hunter 1992
    1. 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. - PubMed
Juni 1999
    1. Juni P, Witschi A, Bloch R, Egger M. The hazards of scoring the quality of clinical trials for meta‐analysis. JAMA 1999;282:1054‐60. - PubMed
Kane 1992
    1. Kane TT, El‐Kady AA, Saleh S, Hage M, Stanback J, Potter L. Maternal mortality in Giza, Egypt: magnitude, causes and prevention. Studies in Family Planning 1992;23(1):45‐7. - PubMed
Leduc 2009
    1. Leduc D, Senikas V, Lalonde AB, Ballerman C, Biringer A, Delaney M, et al. Active management of the third stage of labour: prevention and treatment of postpartum hemorrhage. Journal of Obstetrics & Gynaecology Canada: JOGC 2009;31(10):980‐93. - PubMed
Lewis 2004
    1. Lewis G editor, CEMACH. Why Mothers Die 2000‐2002 ‐ Sixth Report of the Confidential Enquires into Maternal Deaths in the United Kingdom. London: RCOG Press, 2004.
Liabsuetrakul 2007
    1. Liabsuetrakul T, Choobun T, Peeyananjarassri K, Islam QM. Prophylactic use of ergot alkaloids in the third stage of labour. Cochrane Database of Systematic Reviews 2007, Issue 2. [DOI: 10.1002/14651858.CD005456.pub2] - DOI - PubMed
McCormick 2002
    1. McCormick ML, Sanghvi HC, Kinzie B, McIntosh N. Preventing postpartum hemorrhage in low‐resource settings. International Journal of Gynecology & Obstetrics 2002;77(3):267‐75. - PubMed
McDonald 1993
    1. McDonald SJ, Prendiville WJ, Blair E. Randomised controlled trial of oxytocin alone versus oxytocin and ergometrine in active management of the third stage of labour. BMJ 1993;307:1167‐71. - PMC - PubMed
McDonald 2004
    1. McDonald S, Prendiville WJ, Elbourne D. Prophylactic ergometrine‐oxytocin versus oxytocin for the third stage of labour. Cochrane Database of Systematic Reviews 2004, Issue 1. [DOI: 10.1002/14651858.CD000201.pub2] - DOI - PMC - PubMed
Mobeen 2011
    1. Mobeen N, Durocher J, Zuberi N, Jahan N, Blum J, Wasim S, et al. Administration of misoprostol by trained traditional birth attendants to prevent postpartum haemorrhage in homebirths in Pakistan: a randomised placebo‐controlled trial. BJOG: an international journal of obstetrics and gynaecology 2011;118:353‐61. - PMC - PubMed
RevMan 2011 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
Schulz 1995
    1. Schulz KF, Chalmers I, Hayes RJ, Altman DG. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. Journal of the American Academy of Medicine 1995;273:408‐12. - PubMed
Triopon 2010
    1. Triopon G, Goron A, Agenor J, Aya GA, Chaillou AL, Begler‐Fonnier J, et al. Use of carbetocin in prevention of uterine atony during cesarean section. Comparison with oxytocin [Utilisation de la carbetocine lors de la delivrance dirigee au cours des cesariennes. Comparaison avec l'ocytocine]. Gynecologie, Obstetrique & Fertilite 2010;38(12):729‐34. - PubMed
Villar 2006
    1. Villar J, Valladares E, Wojdyla D, Zavaleta N, Carroli G, Velazco A, et al. WHO 2005 global survey on maternal and perinatal health research group. Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America. Lancet 2006;367:1819‐29. - PubMed
Yuen 1995
    1. Yuen PM, Chan NST, Yim SF, Chang AMZ. A randomised double blind comparison of syntometrine and syntocinon in the management of the third stage of labour. British Journal of Obstetrics and Gynaecology 1995;102:377‐80. - PubMed

References to other published versions of this review

Su 2007
    1. Su LL, Chong YS, Samuel M. Oxytocin agonists for preventing postpartum haemorrhage. Cochrane Database of Systematic Reviews 2007, Issue 3. [Art. No.: CD005457. DOI: 10.1002/14651858.CD005457.pub2] - PubMed

Publication types

MeSH terms

LinkOut - more resources