{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T13:30:10Z","timestamp":1789047010316,"version":"build-2803163510"},"reference-count":13,"publisher":"Walter de Gruyter GmbH","issue":"7","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpm-2025-0664_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to compare the efficacy of administering carbetocin before vs. after placental delivery in preventing postpartum hemorrhage (PPH) in low-risk vaginal deliveries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0664_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The randomized controlled trial was conducted at Kartal City Hospital, Istanbul, Turkey. A total of 160 primiparous women with uncomplicated pregnancies who underwent vaginal delivery were enrolled. Participants were randomly assigned to receive 100\u202f\u03bcg of carbetocin either before or after placental delivery. The primary outcome was the incidence of PPH. Secondary outcomes included the need for additional uterotonics, manual removal of the placenta with consequent antibiotic administration, blood transfusions, maternal adverse events, and changes in hemoglobin levels at baseline and 24\u202fh postpartum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0664_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The incidence of PPH was significantly lower in the carbetocin-before group than in the carbetocin-after group (p=0.015). The carbetocin-before group had a significantly lower mean hemoglobin drop compared to the carbetocin-after group (p&lt;0.001). The need for additional uterotonics was significantly higher in the carbetocin-after group (p&lt;0.001). Manual placenta removal and the need for antibiotics were more frequent in the carbetocin-before group (p=0.017). No significant differences in adverse maternal events were observed between the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0664_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Administering carbetocin before placental delivery significantly reduces the incidence of PPH, blood loss, and the need for additional uterotonics. However, the increased rate of manual placenta removal necessitates individualized risk\u2013benefit assessment; pre-placental administration may be most advantageous in women at elevated risk for PPH, in whom the hemorrhagic benefit outweighs the risks associated with manual extraction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpm-2025-0664","type":"journal-article","created":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T00:31:47Z","timestamp":1781310707000},"page":"1127-1133","source":"Crossref","is-referenced-by-count":0,"title":["Timing of carbetocin administration in vaginal deliveries: a double-blind, randomized controlled trial"],"prefix":"10.1515","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7624-3656","authenticated-orcid":false,"given":"P\u0131nar","family":"Y\u0131ld\u0131z","sequence":"first","affiliation":[{"name":"Department of Perinatology , Umraniye Training and Research Hospital , Istanbul , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8099-8883","authenticated-orcid":false,"given":"Esra","family":"Keles","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology , University of Health Sciences, Kartal Doctor L\u00fctfi K\u0131rdar City Hospital , Istanbul , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2546-009X","authenticated-orcid":false,"given":"Gazi","family":"Y\u0131ld\u0131z","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , University of Health Sciences T\u00fcrkey, Kartal Doctor L\u00fctfi K\u0131rdar City Hospital , Istanbul , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9750-1594","authenticated-orcid":false,"given":"Mehmet Mete","family":"K\u0131rlang\u0131\u00e7","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , University of Health Sciences T\u00fcrkey, Kartal Doctor L\u00fctfi K\u0131rdar City Hospital , Istanbul , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9602-9099","authenticated-orcid":false,"given":"Murat Levent","family":"Dereli","sequence":"additional","affiliation":[{"name":"Department of Perinatology , Ministry of Health Denizli State Hospital , Denizli , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5239-6479","authenticated-orcid":false,"given":"Kas\u0131m","family":"Turan","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Private Clinic , Van , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2145-6381","authenticated-orcid":false,"given":"Ay\u015feg\u00fcl","family":"Elmas","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Ministry of Health Hakkari State Hospital , Hakkari , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3965-543X","authenticated-orcid":false,"given":"Emre","family":"Mat","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology , University of Health Sciences, Kartal Doctor L\u00fctfi K\u0131rdar City Hospital , Istanbul , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"2026091012590221438_j_jpm-2025-0664_ref_001","unstructured":"World Health Organization (WHO). WHO recommendations for the prevention and treatment of postpartum haemorrhage. Geneva: WHO; 2012."},{"key":"2026091012590221438_j_jpm-2025-0664_ref_002","doi-asserted-by":"crossref","unstructured":"Vogel, JP, Williams, M, Gallos, I, Althabe, F, Oladapo, OT. WHO recommendations on uterotonics for postpartum haemorrhage prevention: what works, and which one? BMJ Glob Health 2019;4:e001466. https:\/\/doi.org\/10.1136\/bmjgh-2019-001466.","DOI":"10.1136\/bmjgh-2019-001466"},{"key":"2026091012590221438_j_jpm-2025-0664_ref_003","doi-asserted-by":"crossref","unstructured":"Su, LL, Chong, YS, Samuel, M. Carbetocin for preventing postpartum haemorrhage. Cochrane Database Syst Rev 2012;2012:CD005457. https:\/\/doi.org\/10.1002\/14651858.CD005457.pub4.","DOI":"10.1002\/14651858.CD005457.pub3"},{"key":"2026091012590221438_j_jpm-2025-0664_ref_004","doi-asserted-by":"crossref","unstructured":"Leduc, D, Senikas, V, Lalonde, AB, Ballerman, C, Biringer, A, Clinical Practice Obstetrics Committee. Active management of the third stage of labour: prevention and treatment of postpartum hemorrhage. J\u00a0Obstet Gynaecol Can 2009;31:980\u201393. https:\/\/doi.org\/10.1016\/s1701-2163(16)34329-8.","DOI":"10.1016\/S1701-2163(16)34329-8"},{"key":"2026091012590221438_j_jpm-2025-0664_ref_005","doi-asserted-by":"crossref","unstructured":"Widmer, M, Piaggio, G, Nguyen, TMH, Osoti, A, Owa, OO, Misra, S, WHO Champion Trial Group, et al.. Heat-stable carbetocin versus oxytocin to prevent hemorrhage after vaginal birth. N\u00a0Engl J Med 2018;379:743\u201352. https:\/\/doi.org\/10.1056\/nejmoa1805489.","DOI":"10.1056\/NEJMoa1805489"},{"key":"2026091012590221438_j_jpm-2025-0664_ref_006","doi-asserted-by":"crossref","unstructured":"Maged, AM, Hassan, AM, Shehata, NA. Carbetocin versus oxytocin for prevention of postpartum hemorrhage after vaginal delivery in high risk women. 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Health Technol Assess 2019;23:1\u2013356. https:\/\/doi.org\/10.3310\/hta23090.","DOI":"10.3310\/hta23090"},{"key":"2026091012590221438_j_jpm-2025-0664_ref_011","doi-asserted-by":"crossref","unstructured":"Van Dongen, PW, Verbruggen, MM, de Groot, AN, van Roosmalen, J, Sporken, JM, Schulz, M. Ascending dose tolerance study of intramuscular carbetocin administered after normal vaginal birth. Eur J Obstet Gynecol Reprod Biol 1998;77:181\u20137. https:\/\/doi.org\/10.1016\/s0301-2115(97)00260-1.","DOI":"10.1016\/S0301-2115(97)00260-1"},{"key":"2026091012590221438_j_jpm-2025-0664_ref_012","doi-asserted-by":"crossref","unstructured":"Huang, X, Xue, W, Zhou, J, Zhou, C, Yang, F. Effect of carbetocin on postpartum hemorrhage after vaginal delivery: a meta-analysis. 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