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Trial registered on ANZCTR
Registration number
ACTRN12612000466842
Ethics application status
Not yet submitted
Date submitted
24/04/2012
Date registered
27/04/2012
Date last updated
24/07/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
Carbetocin vs Oxytocin at Emergency Caesarean Section
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Scientific title
Carbetocin vs Oxytocin (Syntocinon) to Improve Uterine Tone at Emergency Caesarean Section
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Secondary ID [1]
280384
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nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
post partum haemorrhage at emergency caesarean section
286363
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Condition category
Condition code
Reproductive Health and Childbirth
286607
286607
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0
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Fetal medicine and complications of pregnancy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
100 microgram intravenous(IV) injection of carbetocin will be given immediately after delivery of the baby at emergency caesarean section.
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Intervention code [1]
284749
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Treatment: Drugs
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Intervention code [2]
284765
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Prevention
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Comparator / control treatment
two groups will be included in the trial. both will receive treatment immediately after the baby is born at emergency caesarean section. control: 5 unit syntocinon bolus IV Intervention: 100 micrograms carbetocin IV
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Control group
Active
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Outcomes
Primary outcome [1]
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Need for further uterotonics: which ones.
the operator will subjectively judge if the uterus is atonic. when atony is identified the normal protocol for post partum haemorrhage will be initiated.
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Assessment method [1]
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Timepoint [1]
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after delivery of the fetus and administration of the chosen oxytocic, before closure of the rectal sheath at caesarean section
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Secondary outcome [1]
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Post-operative haemoglobin compared to pre-op
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Assessment method [1]
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Timepoint [1]
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day 1 post caesarean section
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Secondary outcome [2]
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Need for uterine massage for >5minutes
This will be subjectively asessd by the operator
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Assessment method [2]
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Timepoint [2]
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after delivery of the fetus and administration of the chosen oxytocic, bofore closure of the rectal sheath at caesarean section
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Secondary outcome [3]
297222
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Total subjective estimated blood loss in theatre. Suction is used to suck the excess blood into a measuring container. this amount will be recorded and any swabs soaked with blood will be weighed. this amount will be added to the suction amount to give the estimated blood loss
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Assessment method [3]
297222
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Timepoint [3]
297222
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after closure of the skin at caesarean section
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Secondary outcome [4]
297223
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Post-op blood loss (ie not from EBL in theatre).
any swabs/pads will be weighed to estimate the amount of blood lost.
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Assessment method [4]
297223
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Timepoint [4]
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from leaving theatre post caesarean section until 24 hours post caesarean section ( ie primary post partum haemorrhage)
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Secondary outcome [5]
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Fundal height above/below the umbilicus day 1
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Assessment method [5]
297224
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Timepoint [5]
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day 1 post caesarean section
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Eligibility
Key inclusion criteria
anyone having an emergency caesarean section at Frankston Hospital who have given consent to be part of the trial. Age>16. >37 weeks gestation. <3 previous caesarean sections. epidural or spinal anaesthesia
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Minimum age
17
Years
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Maximum age
50
Years
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Sex
Females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
previous adverse reaction to carbetocin/syntocinon. History of vascular, hepatic or renal problems. Lack of consent. <37 weeks gestation. Placenta praevia. Placental abruption. >2 caesarean sections. Patients having an elective caesarean section. general anaesthetic
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
a list of numbers which are randomly assigned either syntocinon or carbetocin will be generated by a computer programme. patients will receive each number in consecutive order. the patient will receive the corresponding vial which has been blinded at pharmacy level.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
the sequence will be produced from a computer programme that generates random lists. this will be done at pharmacy level and none of the oprating or anaesthetic doctors will have access to this.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/08/2012
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
130
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
285153
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Hospital
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Name [1]
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Frankston Hospital
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Address [1]
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Hastings Road
Frankston
3199
Victoria
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Carole-anne Whigham
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Address
Womens Health Unit
Frankston Hospital
Hastings Road
Frankston
3199
Vic
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Country
Australia
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Secondary sponsor category [1]
284015
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Individual
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Name [1]
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Professor A Trivedi
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Address [1]
284015
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Womens Health Unit
Frankston Hospital
Hastings Road
Frankston
3199
Vic
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Country [1]
284015
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Australia
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
287169
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Peninsula Health Human Research Ethics Committee
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Ethics committee address [1]
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Mount Eliza Centre Jacksons Road Mt Eliza VIC 3930
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Ethics committee country [1]
287169
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Australia
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Date submitted for ethics approval [1]
287169
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17/04/2012
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Approval date [1]
287169
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Ethics approval number [1]
287169
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HREC/12/PH/28
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Summary
Brief summary
Reducing maternal mortality rates has been a worldwide goal for many years. Post partum haemorrhage is the main cause of obstetric haemorrhage accounting for 14 million cases worldwide. It is the leading cause of maternal death throughout the world. In Victoria, Australia, in 2002 the post partum haemorrhage rate was 9.2%. Post partum haemorrhage is associated with ICU admission, the need for blood transfusion and a longer hospital stay, which is at considerable cost. The majority of post partum haemorrhage is caused by uterine atony, so finding an effective agent to prevent uterine atony is paramount in reducing maternal morbidity and mortality. Operative delivery is a known risk factor for PPH therefore improving uterine tone at caesarean section is an important parameter if rates are to be reduced. Carbetocin is a synthetic long-acting analogue of oxytocin used to improve uterine tone. Studies have shown that a single intra-muscular injection of carbetocin is more effective than syntocinon infusion for preventing uterine atony at elective caesarean section, and this is the current practice at Frankston Hospital. Carbetocin is currently licensed in Australia to reduce uterine atony at elective caesarean section, however the efficacy at emergency caesarean section is unclear. In this prospective randomised trial we aim to discover if carbetocin 100 micrograms iv or Syntocinon 5 unit iv bolus, is more effective at improving post partum haemorrhage rates in emergency caesarean sections, by measures of need for further uterotonics, need for >5 minutes uterine massage and haemoglobin drop.
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Trial website
nil
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Trial related presentations / publications
nil
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Professor Amar Trivedi
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Address
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Womens Health Unit
Frankston Hospital
Hastings Road
Frankston
3199
Vic
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Country
17352
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Australia
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Phone
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+61427215515
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Carole-Anne Whigham
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Address
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Womens Health Unit
Frankston Hospital
Hastings Road
Frankston
3199
Vic
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Country
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Australia
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Phone
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+61404644029
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Carbetocin versus oxytocin to reduce additional uterotonic use at non-elective caesarean section: a double-blind, randomised trial*.
2016
https://dx.doi.org/10.3109/14767058.2016.1149564
N.B. These documents automatically identified may not have been verified by the study sponsor.
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