V.F.Snegirev Archives of Obstetrics and GynecologyV.F.Snegirev Archives of Obstetrics and Gynecology2313-87262687-1386Eco-Vector35291Research ArticleSumming up a multicenter prospective comparative randomized study of the efficiency and safety of Pabal® (carbetocin) and oxytocinBelomestnovS. R-GalinaT. V-ZhilinA. V-KirbasovaN. P-KozyrenkoE. M-KulikovA. Vkulikov1905@yandex.ruRadzinskyV. E-RymashevskyA. N-KholopovA. V-ShifmanE. M-TskhayV. B-Regional Children’s Hospital № 1Peoples’ Friendship University of RussiaCity Hospital № 29 named after N.E. BaumanI.M. Sechenov First Moscow State Medical UniversityRegional Perinatal CenterUral State Medical UniversityRostov State Medical UniversityMaternity Hospital № 5Department of Health Care of Tomsk RegionMoscow Regional Research and Clinical Institute named after M.F. VladimirskyKrasnoyarsk State Medical UniversityKrasnoyarsk Regional Clinical Center for Maternal and Child Welfare1503201521485421072020Copyright © 2015, Eco-Vector2015A multicenter prospective comparative randomized study was carried out to evaluate the efficiency and safety of Pabal® (carbetocin) and oxitocin, used for prevention of the postpartum hemorrhages in abdominal delivery. The volume of blood loss in patients treated by Pabal (n=163) and oxitocin (n=180) were compared in the patients with uterine cicatrix, large fetus, in cesarean section combined with conservative myomectomy, in twin pregnancy, placental presentation, and preterm detachment of normally located placenta. Pabal proved to be highly effective and safe; blood loss was significantly lower in response to Pabal in comparison with preventive oxitocin.Pabalcarbetocinprevention of postpartum bleedingmulticenter studyПабалкарбетоцинпрофилактика послеродовых кровотечениймногоцентровое исследование[Amsalem H., Aldrich C.J., Oskamp M., Windrim R., Farine D. Postpartum uterine response to oxytocin and carbetocin. J. Reprod. Med. 2014; 59 (3-4): 167-73.][Askar A.A., Ismail M.T., El-Ezz A.A., Rabie N.H. Carbetocin versus syntometrine in the management of third stage of labor following vaginal delivery. Arch. Gynecol. Obstet. 2011; 284 (6): 1359-65.][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 randomized trial. Br. J. Obstet. Gynaecol. 2010; 117 (8): 929-36.][Borruto F., Treisser A., Comparetto C. Utilization of carbetocin for prevention of postpartum hemorrhage after cesarean section: a randomized clinical trial. Arch. Gynecol. Obstet. 2009; 280 (5): 707-12.][Bruyere M., Ait Hamou N., Benhamou D., Chousterman B., Boulard V., Charbit B. QT interval prolongation following carbetocin in prevention of post-cesarean delivery hemorrhage. Int. J. Obstet.Anesth. 2014; 23 (1):88-9.][Carbetocin: a synthetic oxytocin analogue with no clear advantages. Prescrire Int. 2008; 17 (96): 150.][Cordovani D., Balki M., Farine D., Seaward G., Carvalho J.C. Carbetocin at elective Cesarean delivery: a randomized controlled trial to determine the effective dose. Can. J. Anaesth. 2012; 59 (8): 751-7.][De Bonis M., Torricelli M., Leoni L., Berti P., Ciani V., Puzzutiello R. et al. Carbetocin versus oxytocin after caesarean section: similar efficacy but reduced pain perception in women with high risk of postpartum haemorrhage. J. Matern. Fetal Neonat. Med. 2012; 25 (6): 732-5.][Demetz J., Clouqueur E., D’Haveloose A., Staelen P., Ducloy A.S., Subtil D. Systematic use of carbetocin during cesarean delivery of multiple regnancies: a before-and-after study. Arch. Gynecol. Obstet. 2013; 287 (5): 875-80.][Elgafor el Sharkwy I.A. Carbetocin versus sublingual misoprostol plus oxytocin nfusion for prevention of postpartum hemorrhage at cesarean section in patients with risk factors: a randomized, open trail study. Arch. Gynecol. Obstet. 2013; 288 (6): 1231-6.][Feifel D., Shilling P.D., Belcher A.M. The effects of oxytocin and its analog, carbetocin, on genetic deficits in sensorimotor gating. Eur. Neuropsychopharmacol. 2012; 22 (5): 374-8.][Gamboa-Lopez Gde J., Bolado-Garcia P.B., Alvarez-Nemegyei J. Biochemical markers of cardiac damage increased after carbetocin infusion during cesarean section. Rev. Med. Inst. Mex. Seguro Soc. 2012; 50 (5): 477-80.][Gizzo S., Patrelli T.S., Gangi S.D., Carrozzini M., Saccardi C., Zambon A. et al. Which uterotonic is better to prevent the postpartum hemorrhage? Latest news in terms of clinical efficacy, side effects, and contraindications: a systematic review. Reprod. Sci. 2013; 20 (9): 1011-9.][Higgins L., Mechery J., Tomlinson A.J. Does carbetocin for prevention of postpartum haemorrhage at caesarean section provide clinical or financial benefit compared with oxytocin? J. Obstet. Gynaecol. 2011; 31 (8): 732-9.][Holleboom C.A., van Eyck J., Koenen S.V., Kreuwel I. A., Bergwerff F., Creutzberg E.C., Bruinse H.W. Carbetocin in comparison with oxytocin in several dosing regimens for the prevention of uterine atony after elective caesarean section in the Netherlands. Arch. Gynecol. Obstet. 2013; 287 (6): 1111-7.][Kalinka J., Lipinska M., Sosnowski D., Wilinski W., Skoczylas M., Serafin M. et al. Evaluation of carbetocin (pabal) efficacy in the prevention of the postpartum hemorrhage in women after cesarean section-preliminary report. Ginekol. Pol. 2009; 80 (7): 512-7.][Karpenko I.A., Kreder R., Valencia C., Villa P., Mendre C., Mouillac B. et al. Red fluorescent turn-on ligands for imaging and quantifying G protein-coupled receptors in living cells. ChemBioChem. 2014; 15 (3) : 359-63.][Larciprete G., Montagnoli C., Frigo M., Panetta V., Todde C., Zuppani B. et al. Carbetocin versus oxytocin in caesarean section with high risk of post-partum haemorrhage. J. Prenat. Med. 2013; 7 (1): 12-8.][Moertl M.G., Friedrich S., Kraschl J., Wadsack C., Lang U., Schlembach D. Haemodynamic effects of carbetocin and oxytocin given as intravenous bolus on women undergoing caesarean delivery: a randomised trial. Br. J. Obstet. Gynaecol. 2011; 118 (11): 1349-56.][Nirmala K., Zainuddin A.A., Ghani N.A., Zulkifli S., Jamil M.A. Carbetocin versus syntometrine in prevention of post-partum hemorrhage following vaginal delivery. J. Obstet. Gynaecol. Res. 2009; 35 (1): 48-54.][Ortiz-Gomez J.R., Morillas-Ramirez F., Fornet-Ruiz I., Palacio-Abizanda F.J., Bermejo-Albares L. Clinical and pharmacological study of the efficacy of carbetocin in elective caesareans compared to low and usual doses of oxytocin. Rev. Esp. Anestesiol. Reanim. 2013; 60 (1): 7-15.][Posadas Robledo F.J. Carbetocin use to prevent obstetric hemorrhage. Ginecol. Obstet. Mex. 2011; 79 (7): 419-27.][Rath W. Prevention of postpartum haemorrhage with the oxytocin analogue carbetocin. Eur. J. Obstet. Gynecol. Reprod. Biol. 2009; 147 (1): 15-20.][Reyes O.A., Gonzalez G.M. Carbetocin versus oxytocin for prevention of postpartum hemorrhage in patients with severe preeclampsia: a double-blind randomized controlled trial. J. Obstet. Gynaecol. Can. 2011; 33 (11): 1099-104.][Rosseland L.A., Hauge T.H., Grindheim G., Stubhaug A., Langesaeter E. Changes in lood pressure and cardiac output during cesarean delivery: the effects of oxytocin and carbetocin compared with placebo. Anesthesiology. 2013; 119 (3): 541-51.][Steckler D., Naidoo V., Gerber D., Kahn W. Ex vivo influence of carbetocin on equine myometrial muscles and comparison with oxytocin. Theriogenology. 2012; 78 (3): 502-9.][Su L.L., Chong Y.S., Samuel M. Carbetocin for preventing postpartum haemorrhage. Cochrane Database Syst. Rev. 2012; 4: CD005457.][Su L.L., Chong Y.S., Samuel M. Carbetocin for preventing postpartum haemorrhage. Cochrane Database Syst. Rev. 2012; 2: CD005457.][Su L.L., Rauff M., Chan Y.H., Mohamad Suphan N., Lau T.P., Biswas A., Chong Y.S. Carbetocin versus syntometrine for the third stage of labour following vaginal delivery - a double-blind randomised controlled trial. Br. J. Obstet. Gynaecol. 2009; 116 (11): 1461-6.][Triopon G., Goron A., Agenor J., Aya G.A., Chaillou A.L., Begler-Fonnier J. et al. Use of carbetocin in prevention of uterine atony during cesarean section. Comparison with oxytocin. Gynecol. Obstet. Fertil. 2010; 38 (12): 729-34.]