{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:11:16Z","timestamp":1777633876376,"version":"3.51.4"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Data with a high level of evidence is lacking on the use of prophylactic uterotonic drug following vaginal delivery to prevent postpartum hemorrhage (PPH) among women who were considered high\u2010risk for PPH. Our main objective was to compare the effectiveness of prophylactic carbetocin versus oxytocin in preventing PPH after vaginal delivery among women at high risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective before\u2010and\u2010after single\u2010center comparative study, including all high\u2010risk women after vaginal births. Two consecutive 14\u2010month periods were compared, where the prophylactic methods to prevent PPH differed: oxytocin (5\u2009IU IV) versus carbetocin (100\u2009\u03bcg IV) given immediately after vaginal delivery. High\u2010risk women were defined by at least one of the following criteria: previous PPH (blood loss \u2265500\u2009mL), antenatal suspicion of macrosomia (estimated fetal weight &gt;90th p), twin pregnancy, repeated cervical ripening methods, polyhydramnios, multiparity (\u22654), and rapid labor (&lt;2\u2009h) without analgesia. The primary outcome was PPH. Secondary outcomes included severe PPH (blood loss \u22651000\u2009mL), second\u2010line uterotonic agents, surgical hemostatic procedures, uterine artery embolization, and maternal morbidity. Groups were matched 1:1 by risk criteria. Outcomes were assessed using univariate analysis, multivariable logistic regression, and propensity score adjustment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 754 women (377 per group) were included. Maternal and labor characteristics were comparable. Rates of PPH and severe PPH were similar with carbetocin versus oxytocin (7.4% vs. 9.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.36; 2.9% vs. 2.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.83). The need for second\u2010line uterotonics (additional oxytocin and\/or sulprostone) was significantly lower with carbetocin (3.7% vs. 12.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Other secondary outcomes did not differ. After adjustment for potential confounders (history of PPH, BMI, intrapartum fever), prophylactic carbetocin was not associated with increased risk of PPH (aOR\u2009=\u20091.85, 95% CI [0.97 to 3.57]). Propensity score analysis confirmed these findings (aOR\u2009=\u20091.33, 95% CI [0.74 to 1.72]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prophylactic carbetocin was associated with a similar rate of PPH in high\u2010risk women after vaginal delivery, compared with oxytocin, but significantly reduced the use of oxytocin when carbetocin was used as the first\u2010line agent, although there was no difference in the use of prostaglandins or invasive procedures to manage persistent PPH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70180","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T08:15:52Z","timestamp":1772957752000},"page":"940-947","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prophylactic carbetocin versus oxytocin following vaginal delivery among women with high risk for postpartum hemorrhage: A before\u2010and\u2010after study"],"prefix":"10.1111","volume":"105","author":[{"given":"Margot","family":"Sauvee","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Centre Hospitalier Departemental  La Roche sur Yon France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emelyne","family":"Lefizelier","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Centre Hospitalier Departemental  La Roche sur Yon France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louen","family":"Ropers","sequence":"additional","affiliation":[{"name":"Clinical Research Center Centre Hospitalier Departemental  La Roche sur Yon France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerome","family":"Dimet","sequence":"additional","affiliation":[{"name":"Clinical Research Center Centre Hospitalier Departemental  La Roche sur Yon France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2549-353X","authenticated-orcid":false,"given":"Guillaume","family":"Ducarme","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Centre Hospitalier Departemental  La Roche sur Yon France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogoh.2017.09.002"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-016-1217-0"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70227-X"},{"key":"e_1_2_13_5_1","unstructured":"WHO recommendations Uterotonics for the prevention of postpartum haemorrhage. Web annex 7: Choice of uterotonic agents."},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2018.04.002"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011689.pub2"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004228"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000782"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14938"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-018-4806-5"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2015.1011121"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14743"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/6420738"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-021-02127-7"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1805489"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.18358"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-020-05834-x"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.16097"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.70180","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.70180","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.70180","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T04:57:37Z","timestamp":1777438657000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.70180"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,24]]},"references-count":18,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/aogs.70180"],"URL":"https:\/\/doi.org\/10.1111\/aogs.70180","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,24]]},"assertion":[{"value":"2025-10-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}