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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| Veröffentlicht in: | Journal of clinical medicine 2021-08, Vol.10 (17), p.3767 |
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| creator | Degez, Manon Planche, Lucie Dorion, Agnès Duchalais, Alexis Lefizelier, Emelyne Ducarme, Guillaume |
| 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%; p = 0.08). Previous PPH (p < 0.001), a cesarean section during labor (p = 0.01), cervical ripening (p = 0.02), and birthweight (p = 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. |
| doi_str_mv | 10.3390/jcm10173767 |
| format | Article |
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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%; p = 0.08). Previous PPH (p < 0.001), a cesarean section during labor (p = 0.01), cervical ripening (p = 0.02), and birthweight (p = 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.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm10173767</identifier><identifier>PMID: 34501215</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Anemia ; Birth weight ; Blood transfusions ; Body mass index ; Cesarean section ; Clinical medicine ; Embolization ; Gestational age ; Hemoglobin ; Hypertension ; Hysterectomy ; Induced labor ; Medical records ; Obesity ; Postpartum period ; Preeclampsia ; Pregnancy ; Prevention ; Risk factors ; Sociodemographics ; Software ; Sutures ; Ultrasonic imaging ; Vagina ; Veins & arteries ; Womens health</subject><ispartof>Journal of clinical medicine, 2021-08, Vol.10 (17), p.3767</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). 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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%; p = 0.08). Previous PPH (p < 0.001), a cesarean section during labor (p = 0.01), cervical ripening (p = 0.02), and birthweight (p = 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. 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Planche, Lucie ; Dorion, Agnès ; Duchalais, Alexis ; Lefizelier, Emelyne ; Ducarme, Guillaume</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c386t-d3c9385e4daf020609c47d5d012e151d676c0e0082491efb41474192ee8fd3693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anemia</topic><topic>Birth weight</topic><topic>Blood transfusions</topic><topic>Body mass index</topic><topic>Cesarean section</topic><topic>Clinical medicine</topic><topic>Embolization</topic><topic>Gestational age</topic><topic>Hemoglobin</topic><topic>Hypertension</topic><topic>Hysterectomy</topic><topic>Induced labor</topic><topic>Medical records</topic><topic>Obesity</topic><topic>Postpartum period</topic><topic>Preeclampsia</topic><topic>Pregnancy</topic><topic>Prevention</topic><topic>Risk factors</topic><topic>Sociodemographics</topic><topic>Software</topic><topic>Sutures</topic><topic>Ultrasonic imaging</topic><topic>Vagina</topic><topic>Veins & arteries</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Degez, Manon</creatorcontrib><creatorcontrib>Planche, Lucie</creatorcontrib><creatorcontrib>Dorion, Agnès</creatorcontrib><creatorcontrib>Duchalais, Alexis</creatorcontrib><creatorcontrib>Lefizelier, Emelyne</creatorcontrib><creatorcontrib>Ducarme, Guillaume</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Degez, Manon</au><au>Planche, Lucie</au><au>Dorion, Agnès</au><au>Duchalais, Alexis</au><au>Lefizelier, Emelyne</au><au>Ducarme, Guillaume</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk Factors for Carbetocin Failure after a Cesarean Section: Is Obesity One of Them?</atitle><jtitle>Journal of clinical medicine</jtitle><date>2021-08-24</date><risdate>2021</risdate><volume>10</volume><issue>17</issue><spage>3767</spage><pages>3767-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>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%; p = 0.08). Previous PPH (p < 0.001), a cesarean section during labor (p = 0.01), cervical ripening (p = 0.02), and birthweight (p = 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.</abstract><cop>Basel</cop><pub>MDPI AG</pub><pmid>34501215</pmid><doi>10.3390/jcm10173767</doi><orcidid>https://orcid.org/0000-0002-2549-353X</orcidid><oa>free_for_read</oa></addata></record> |
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| source | PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Anemia Birth weight Blood transfusions Body mass index Cesarean section Clinical medicine Embolization Gestational age Hemoglobin Hypertension Hysterectomy Induced labor Medical records Obesity Postpartum period Preeclampsia Pregnancy Prevention Risk factors Sociodemographics Software Sutures Ultrasonic imaging Vagina Veins & arteries Womens health |
| title | Risk Factors for Carbetocin Failure after a Cesarean Section: Is Obesity One of Them? |
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