Postpartum hemorrhage is a preventable event in abdominal and vaginal seliviries. Conventional incremental dosing or continous infusion of oxytocin has been employed for these. Carbetocin, as an anlogue is associated with longer half-life and has clinical benefits.

OBJECTIVE: The objective was to compare the effectiveness of carbetocin and oxytocin when administered after elective uncomplicated cesarean section (CS) for the prevention of postpartum hemorrhage.

DESIGN: Randomized single blind controlled trial of patients admitted at Rizal Medical Center from June to October 2012.

PARTICIPANTS AND METHODS: A total of 70 patients were randomized to carbetocin (n=35) and oxytocin (n=35) for the prevention of postpartum hemorrhage and analyzed by intention-to treat. Baseline demographic and obstetric profile, indications for CS, estimated blood loss, hematocrit, hemoglobin, need for uterine massage, additional uterotonics, uterine tone and involution were compared immediate post-operative and 24 hours after.

RESULTS: Baseline profiles were similar between the two groups. Post-operatively, hemoglobin and hematocrit levels in the carbetocin in group were statistically significant and were associated with lesser need for additional uterotonic agents, uterine massage and a well contracted uterus immediate post-operative and 24 hours thereafter. The estimated blood loss was significantly lower in the carbetocin group however , the two groups did not significantly differ in terms of blood transfusion requirements and post-op blood pressure.

CONCLUSION: Carbetocin as a uterotonic agent is an acceptable alternative for the prevention of postpartum bleeding in elective cesarean section. A cost-benefit analysis is mandated. 

Human ; Female ; Carbetocin ; Oxytocin ; Postpartum Hemorrhage ; Blood Pressure ; Half-life ; Hematocrit ; Oxytocics ; Cesarean Section ; Postpartum Period

A 31 year old Filipino male diagnosed with obstructive azoospermia underwent TESE. Other current advanced sperm retrieval techniques include MESA, PESA and TESA confounded with female factors such as advanced maternal age and polycystic ovaries, IVF-ICSI eventually resulted to a successful pregnacy outcome. Several factors contributing to the success of IVF-ICSI eventually resulted to a successful pregnancy outcome. Several factors contributing to the success of IVF-ICSI in this case were also discussed. Although assisted reproductive technology is relatively new in our country, it proved to be promising in our local setting.
Human ; Female ; Adult ; REPRODUCTIVE TECHNIQUES, ASSISTED ; AZOOSPERMIA ; SPERM RETRIEVAL

A 31 year old Filipino male diagnosed with obstructive azoospermia underwent TESE. Other current advanced sperm retrieval techniques include MESA, PESA and TESA confounded with female factors such as advanced maternal age and polycystic ovaries, IVF-ICSI eventually resulted to a successful pregnacy outcome. Several factors contributing to the success of IVF-ICSI eventually resulted to a successful pregnancy outcome. Several factors contributing to the success of IVF-ICSI in this case were also discussed. Although assisted reproductive technology is relatively new in our country, it proved to be promising in our local setting.
Human ; Female ; Adult ; Reproductive Techniques, Assisted ; Azoospermia ; Sperm Retrieval

The first local case of a 37 year old Gravida 5 Para 3 (2-1-2-3) with adrenocortical carcinoma who developed metastases during pregnancy is reported. Patient initially presented with signs and symptoms of Cushings and virilization. Ultrasound revealed a solid suprarenal mass. Biochemical evaluation showed increased levels of urinary cortisol, 17-ketosteroids, serum testosterone and serum DHEA-S. Adrenalectomy revealed adrenocortical carcinoma. Complications developed at 31 weeks AOG necessitating early termination of pregnancy. In the absence of a more effective treatment modality, chemotherapy was started obtaining optimum outcome for both the mother and the fetus.
Human ; Female ; Adult ; ADRENAL GLAND NEOPLASMS ; PREGNANCY