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Active management of third stage of labour (i.e., administration of an uterotonic
soon after birth of the baby, delayed cord clamping and delivery of the placenta by
controlled cord traction, followed by uterine massage) has been proven to be effective
in the prevention of post-partum haemorrhage (PPH). A number of uterotonic
agents have been proposed, including the newly developed carbetocin.
Key messages
􀃎 The available evidence is insufficient to make any sound recommendation on
the use of carbetocin as a routine first-line uterotonic agent.
􀃎 More larger trials are needed to allow better assessment of the efficacy of
carbetocin particularly whether the medication leads to reduction of the rates
of PPH.


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