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Related Experiment Video

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Extra Cellular Matrix-Based and Extra Cellular Matrix-Free Generation of Murine Testicular Organoids

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Carbetocin: Worth the extra expense?

Ioannis D Gallos¹, Arri Coomarasamy¹

¹From Institute of Metabolism and Systems Research (IMSR), University of Birmingham, UK.

Best Practice & Research. Clinical Obstetrics & Gynaecology

|June 6, 2019

Summary

Post-partum haemorrhage (PPH) is a major cause of maternal death. Heat-stable carbetocin offers a promising, effective alternative to oxytocin for PPH prevention in low-resource settings.

Keywords:

Carbetocin Oxytocin PPH prevention Postpartum haemorrhage Third stage

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Area of Science:

Obstetrics and Gynecology
Maternal Health
Pharmacology

Background:

Post-partum haemorrhage (PPH) claims a maternal life every six minutes in low- and middle-income countries (LMICs).
Routine uterotonic agents are critical for PPH prevention globally.
Oxytocin, the current standard, requires a cold chain, posing challenges in resource-limited settings.

Purpose of the Study:

To evaluate heat-stable carbetocin as a viable alternative to oxytocin for PPH prevention.
To address the limitations of oxytocin's cold chain requirement in LMICs.
To assess the efficacy and safety profile of carbetocin compared to oxytocin.

Main Methods:

Systematic review and meta-analysis of existing evidence comparing heat-stable carbetocin and oxytocin for PPH prevention.
Analysis of drug stability, side effect profiles, and cost-effectiveness.
Examination of global registration and accessibility initiatives.

Main Results:

Heat-stable carbetocin demonstrates comparable efficacy and a favorable side effect profile to oxytocin.
Carbetocin's heat stability overcomes the cold chain limitations associated with oxytocin.
Current high cost and limited availability hinder widespread carbetocin adoption, though initiatives are underway to improve access.

Conclusions:

Heat-stable carbetocin presents a significant advancement for PPH prevention, particularly in LMICs lacking reliable cold chains.
The World Health Organization's agreement to provide carbetocin at a lower cost aims to make it accessible.
Increased registration and availability of carbetocin in 90 LMICs promise improved maternal health outcomes.