Carbetocin Versus Oxytocin Plus Sublingual Misoprostol in the Management of Atonic Postpartum Hemorrhage
Primary Purpose
Postpartum Hemorrhage
Status
Completed
Phase
Not Applicable
Locations
Egypt
Study Type
Interventional
Intervention
oxytocin
oxytocin plus misoprostol
Carbetocin
Sponsored by
About this trial
This is an interventional treatment trial for Postpartum Hemorrhage focused on measuring Postpartum Hemorrhage, vaginal delivery, carbetocin, misoprostol, oxytocin
Eligibility Criteria
Inclusion Criteria:
- All participants had PPH defined as vaginal bleeding>500 ml after vaginal delivery and uterine atony confirmed by abdominal palpation
Exclusion Criteria:
- gestational age<37 weeks,
- genital tract trauma,
- coagulation defect,
- women with hypertension, preeclampsia, cardiac, renal or liver diseases, epilepsy
- known hypersensitivity to carbetocin or oxytocin.
Sites / Locations
- Aswan University Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Active Comparator
Active Comparator
Active Comparator
Arm Label
oxytocin
oxytocin plus misoprostol
Carbetocin
Arm Description
The patient will be received oxytocin 20 IU by intravenous infusion
The patient will be received oxytocin 20 IU by intravenous infusion plus 400 mc sublingual misoprostol
The patient will be received Carbetocin 100 mic gm IV
Outcomes
Primary Outcome Measures
The amount of blood loss
calculation of the amount of blood loss by weighing the swabs and using pictorial charts
Secondary Outcome Measures
The number of patients develop blood loss more than 1000 ml
Calculation of the number of patients develop blood loss more than 1000 ml
The number of patient need blood transfusion
Calculation of number of patient need blood transfusion
Full Information
NCT ID
NCT03870503
First Posted
March 9, 2019
Last Updated
September 27, 2021
Sponsor
Aswan University Hospital
1. Study Identification
Unique Protocol Identification Number
NCT03870503
Brief Title
Carbetocin Versus Oxytocin Plus Sublingual Misoprostol in the Management of Atonic Postpartum Hemorrhage
Official Title
Carbetocin Versus Oxytocin Plus Sublingual Misoprostol in the Management of Atonic Post-partum Hemorrhage (PPH) After Vaginal Delivery: a Randomized Controlled Trial
Study Type
Interventional
2. Study Status
Record Verification Date
September 2021
Overall Recruitment Status
Completed
Study Start Date
April 1, 2019 (Actual)
Primary Completion Date
June 30, 2021 (Actual)
Study Completion Date
August 1, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Aswan University Hospital
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The objective of this study is to compare the effectiveness and safety of carbetocin vs. oxytocin plus sublingual misoprostol in the management of atonic postpartum hemorrhage (PPH)after vaginal delivery.
Detailed Description
The first cause of hemorrhage at the time of delivery is uterine atony; therefore, there is general agreement that active management of the third stage of labor is recommended.
Oxytocin is the most widely used uterotonic agent but has a half-life of only 4-10 min, that is why it is better administered as a continuous intravenous infusion to achieve sustained uterotonic activity. Carbetocin is a synthetic long-acting oxytocin agonistic analog with prolonged half-life prolonging its pharmacological effects. Its prolonged uterine activity may theoretically offer advantages over oxytocin in the management of the third stage of labor. The side-effect profile of carbetocin was not found to be different from that of Oxytocin but may prove to be advantageous when compared to Syntometrine.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Postpartum Hemorrhage
Keywords
Postpartum Hemorrhage, vaginal delivery, carbetocin, misoprostol, oxytocin
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
This study will be a prospective double-blind randomized study
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
This study will be a prospective double-blind randomized study
Allocation
Randomized
Enrollment
135 (Actual)
8. Arms, Groups, and Interventions
Arm Title
oxytocin
Arm Type
Active Comparator
Arm Description
The patient will be received oxytocin 20 IU by intravenous infusion
Arm Title
oxytocin plus misoprostol
Arm Type
Active Comparator
Arm Description
The patient will be received oxytocin 20 IU by intravenous infusion plus 400 mc sublingual misoprostol
Arm Title
Carbetocin
Arm Type
Active Comparator
Arm Description
The patient will be received Carbetocin 100 mic gm IV
Intervention Type
Drug
Intervention Name(s)
oxytocin
Other Intervention Name(s)
Active comparator
Intervention Description
The patient will be received oxytocin 20 IU by intravenous infusion
Intervention Type
Drug
Intervention Name(s)
oxytocin plus misoprostol
Other Intervention Name(s)
Active Comparator
Intervention Description
The patient will be received oxytocin 20 IU by intravenous infusion plus 400 mic gm sublingual misoprostol
Intervention Type
Drug
Intervention Name(s)
Carbetocin
Other Intervention Name(s)
Active Comparator
Intervention Description
The patient received Carbetocin 100 mic gm
Primary Outcome Measure Information:
Title
The amount of blood loss
Description
calculation of the amount of blood loss by weighing the swabs and using pictorial charts
Time Frame
6 hours post delivery
Secondary Outcome Measure Information:
Title
The number of patients develop blood loss more than 1000 ml
Description
Calculation of the number of patients develop blood loss more than 1000 ml
Time Frame
24 hours post delivery
Title
The number of patient need blood transfusion
Description
Calculation of number of patient need blood transfusion
Time Frame
24 hours post delivery
10. Eligibility
Sex
Female
Gender Based
Yes
Gender Eligibility Description
All participants had PPH defined as vaginal bleeding>500 ml after vaginal delivery and uterine atony confirmed by abdominal palpation
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
All participants had PPH defined as vaginal bleeding>500 ml after vaginal delivery and uterine atony confirmed by abdominal palpation
Exclusion Criteria:
gestational age<37 weeks,
genital tract trauma,
coagulation defect,
women with hypertension, preeclampsia, cardiac, renal or liver diseases, epilepsy
known hypersensitivity to carbetocin or oxytocin.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
hany f allam, md
Organizational Affiliation
Aswan University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Aswan University Hospital
City
Aswan
ZIP/Postal Code
81528
Country
Egypt
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
33232518
Citation
Parry Smith WR, Papadopoulou A, Thomas E, Tobias A, Price MJ, Meher S, Alfirevic Z, Weeks AD, Hofmeyr GJ, Gulmezoglu AM, Widmer M, Oladapo OT, Vogel JP, Althabe F, Coomarasamy A, Gallos ID. Uterotonic agents for first-line treatment of postpartum haemorrhage: a network meta-analysis. Cochrane Database Syst Rev. 2020 Nov 24;11(11):CD012754. doi: 10.1002/14651858.CD012754.pub2.
Results Reference
derived
Learn more about this trial
Carbetocin Versus Oxytocin Plus Sublingual Misoprostol in the Management of Atonic Postpartum Hemorrhage
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