Carbetocin combined with ergometrine maleate for prevention of postpartum hemorrhage in puerperae with cesarean scar pregnancy and its effects on coagulation function

He Wenying; Kang Yinglin

doi:10.3969/j.issn.1672-8157.2025.04.017

Abstract：Objective To explore the efficacy of carbetocin combined with ergometrine maleate in the prevention of postpar-tum hemorrhage in puerperae with cesarean scar pregnancy and its effects on coagulation function.Methods A total of 2 160 puerperae with cesarean scar pregnancy who underwent delivery in Guang'an People's Hospital from January 2020 to January 2022 were selected and divided into the observation group(n=1 080)and control group(n=1 080)by the simple random grouping method.The patients in the control group were given oxytocin combined with carbetocin after delivery while those in the observation group were given ergometrine maleate in addition to carbetocin.The coagulation function indicators(D-dimer(D-D),prothrombin time(PT),fibrinogen(FIB))in the two groups were recorded before delivery and at the 2nd hour after delivery.The decrease of hemoglobin(Hb)and decrease of red blood cell(RBC)before delivery and 1 day after delivery,amount of bleeding in 1 hour,2 hours and 1 day after delivery and the height of fundus in 1 day,3 days and 5 days after delivery were compared between the two groups.The adverse reactions(headache,nausea,vomiting,increased blood pressure)were recorded in the two groups within 5 days after delivery.Results In 2 hours after delivery,serum D-D level and PT value were reduced in both groups as compared with those before delivery,and the level of se-rum D-D of(3.02±0.36)g·mL-1 in the observation group was lower than that of(3.25±0.43)g·mL-1 in the control(P<0.05).However,there was no statistical significance in PT value between the two groups((11.64±1.36)s vs(11.72±1.14)s)(P>0.05).Serum FIB level of the two groups was increased,and it was significantly higher in the observation group than in the control((5.97±0.82)g·mL-1 vs(5.08±0.54)g·mL-1,P<0.05).The decrease of Hb and RBC in observation group were(0.36±0.08)g·L-1 and(13.30±1.12)×109·L-1,which were lower than that of(0.42±0.10)g·L-1 and(15.41±1.56)×109·L-1 in the control(P<0.05).The bleeding amount within 1 hour,2 hours and 1 day after delivery in observation group were(183.57±18.76)mL,(324.57±25.86)mL and(389.94±40.43)mL,which were lower than those of(232.49±16.83)mL,(404.39±34.96)mL and(521.42±41.39)mL in the control(P<0.05).At 1 day after delivery,there was no statistical difference in the height of fundus between the two groups(P>0.05).In 3 days and 5 days after delivery,the heights of fundus of(16.54±1.92)cm and(13.84±1.42)cm in the observation group were shorter than those of(17.49±1.63)cm and(15.79±1.56)cm in the control(P<0.05).Within 5 days after delivery,the total incidence of adverse reactions was 22.31% in the observation group and 24.35% in the control,showing no significant difference(P>0.05).Conclusion The appli-cation of carbetocin combined with ergometrine maleate for puerperae with cesarean scar pregnancy can reduce postpartum hemor-rhage,improve postpartum coagulation function,and speed up uterine recovery with good safety.