Taiwanese journal of obstetrics & gynecology
-
Taiwan J Obstet Gynecol · Jun 2018
Meta AnalysisCarbetocin versus oxytocin for the prevention of postpartum hemorrhage: A meta-analysis of randomized controlled trials in cesarean deliveries.
Postpartum hemorrhage remains the leading cause of maternal mortality in developing countries and a significant proportion of these cases are attributable to uterine atony. In contrast to the advances made in the treatment of postpartum hemorrhage, there has been few novel prophylactic agents. This study was undertaken to analyze the effectiveness of carbetocin compared to oxytocin for the prevention of postpartum hemorrhage, in the context of cesarean deliveries. ⋯ Carbetocin is effective in reducing the use of additional uterotonics, reduction in postpartum hemorrhage and transfusion when used during cesarean deliveries. However, despite the potential benefits illustrated in this meta-analysis, the disparity between the cost of carbetocin and oxytocin suggests that locoregional cost-effectiveness analysis should be performed before any decision is made to adopt it for routine prophylaxis.
-
Taiwan J Obstet Gynecol · Jun 2018
Mechanical induction of labor and ecbolic-less vaginal birth after cesarean section: A cohort study.
During delivery counseling, some women with previous uncomplicated cesarean section (CS) wish mechanical induction of labor (IOL) but they are not accepting the added risk of using ecbolics to induce and/or augment labor. The objective of the study was to assess the safety and efficacy of the isolated use of transcervical Foley's catheter balloon as a mean of mechanical cervical ripening (CR)/IOL and successful ecbolic-less vaginal birth after cesarean section (VBAC). ⋯ Mechanical IOL with the mere use of transcervical Foley's catheter is a safe and effective method of VBAC in women refusing use of ecbolics.