None listed
Conditions
Brief summary
Retained placenta is a common complication following medical termination of pregnancy >13 weeks' or induction of labour for fetal demise, occurring in 19% of cases. The standard of care in our hospital is to administer intramuscular oxytocin 10IU with delivery of the fetus. A small randomised controlled trial compared use of intravenous carbetocin to oxytocin in this cohort and found a significant reduction in rate of placental retention, third stage blood loss and need for surgical curettage. We aim to randomise pregnant people >13 weeks' gestation who are undergoing medical termination or induction of labour for fetal demise to either intravenous carbetocin 100mcg or intramuscular oxytocin 10IU (standard of care) for third stage management. The primary outcome is reduction in incidence of placental retention. The secondary outcomes include total blood loss with delivery, duration of hospital stay, use of additional uterotonics, blood transfusion, high dependency unit admission, incidence of infection post delivery, need for further intervention for retained products of conception and cost effectiveness between the two groups.
Interventions
Intravenous Carbetocin 100micrograms administered by the midwife caring for the patient, over 60 seconds as soon as the fetus is delivered.
Adherence to the intervention (or control) will be checked in the medical records when trial data is collected.
Sponsors
King Edward Memorial Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Pregnant people 18 years or older undergoing: - 2nd or 3rd trimester medical termination of pregnancy (13 weeks' gestation or above) OR - 2nd or 3rd trimester fetal demise (13 weeks' gestation or above) planned for induction of labour. Multiple gestations and those with medical co-morbidities are included.
Exclusion criteria
Known allergy to intramuscular oxytocin or carbetocin injection.
Outcome results
None listed