卡贝霉素:治疗产后出血的新首选药物

Sonia Martilova, Nadiah Ushbah, Andhika Ardi Perdana
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摘要

背景:产后出血定义为阴道分娩胎儿后(或剖宫产后>1000 mL)女性生殖道出血超过500 mL。病例介绍:FA女士,31岁,G2P1A0,孕40周龄,先兆子痫,主诉呼吸困难,腿肿。体格检查显示足部饱和度降低,血压升高,肿胀,凹陷性水肿。x线示心脏肿大伴肺水肿,肝酶升高,LEA值+3,实验室检查完全代偿性呼吸性碱中毒,电解质失衡。剖宫产后4小时出现产后出血,因最大限度使用子宫强张剂给予催产素,MgSO4停用,患者报告出现产后子痫。结论:考虑到催产素的副作用,许多研究讨论用其他药物替代催产素以预防产后出血。卡贝菌素可能是一种副作用小的强效子宫扩张药物。
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Carbetocin: The New Preferred Treatment For Partum Hemorrhage
Background: Postpartum hemorrhage defined as the condition blood loss more than 500 mL from the female genital tract after vaginal delivery of the fetus (or >1000 mL after cesarean section). Case Presentation: Mrs. FA 31 year’s old G2P1A0 40 weeks age gestation preeclampsia with main complaints dyspnea and swollen legs. Physical examination showed decreased saturation, increase blood pressure, rhonci, and pitting edema of the pedal. Cardiomegaly with pulmonary edema on x-ray, elevated liver enzymes, LEA value +3, perfectly compensated respiratory alkalosis and electrolyte imbalance on laboratory test. Four-hour post C-section she got postpartum hemorrhagic and given oxytocin due to maximizing use of uterotonic agent, MgSO4 stopped and patient reported with postpartum eclampsia. Conclusion: Many studies discus other drugs to replace oxytocin, considering side effects to prevent postpartum hemorrhage. Carbetocin could be one potent agent of uterotonic agents with lower side effect.
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