Evidence map›Paper›PMID 29949473›Full record

Trial reportThe New England journal of medicine2018

Heat-Stable Carbetocin versus Oxytocin to Prevent Hemorrhage after Vaginal Birth.

Mariana Widmer, Gilda Piaggio, Thi M H Nguyen, Alfred Osoti, Olorunfemi O Owa, Sujata Misra, Arri Coomarasamy, Hany Abdel-Aleem, Ashalata A Mallapur, Zahida Qureshi and 17 more

Registry-linked trialOpen access · bronzeAbstract readComparative StudyEquivalence TrialMulticenter Study
PubMed Publisher
In one paragraph

Trial report in The New England journal of medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06351969 (Evaluating Placental Thickness and Thickness of Uterine Muscle at Placenta Attachment in Prediction of Postpartum Blood Loss in Placenta Accreta), which is not on this map. Cited by 77 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
77citing papers in PubMed, 12 pooled it
31.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06351969 not yet recruitingnot on this mapstarted 2025, after this paper: background citation

Evaluating Placental Thickness and Thickness of Uterine Muscle at Placenta Attachment in Prediction of Postpartum Blood Loss in Placenta Accreta

TypeobservationalSponsorBenha UniversityRan2025 to 2026Enrolled150ConditionsPost Partum Hemorrhage
3 · Its place in the literature

Who cites it

77 citing papers in PubMed, 12 syntheses or guidelines pooled it, 188 citations in OpenAlex.

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  6. Effect of Carbetocin on Postpartum Hemorrhage after Vaginal Delivery: A Meta-Analysis.Computational and mathematical methods in medicine · 2022
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  18. Obstetric pharmacoeconomics.Expert review of pharmacoeconomics & outcomes research · 2026
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17 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

27 authors at 19 institutions in 12 countries.

Mariana WidmerFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Gilda PiaggioFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Thi M H NguyenFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Alfred OsotiFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Olorunfemi O OwaFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Sujata MisraFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Arri CoomarasamyFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Hany Abdel-AleemFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Ashalata A MallapurFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Zahida QureshiFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Pisake LumbiganonFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Archana B PatelFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Guillermo CarroliFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Bukola FawoleFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Shivaprasad S GoudarFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Yeshita V PujarFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
James NeilsonFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
G Justus HofmeyrFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Lin L SuFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Jose Ferreira de CarvalhoFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Uma PandeyFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Kidza MugerwaFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Shobha S ShiragurFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Josaphat ByamugishaFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
Daniel GiordanoFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
A Metin GülmezogluFrom the Department of Reproductive Health and Research, World Health Organization (WHO), United Nations Development Program-United Nations Population Fund-UNICEF-WHO-World Bank Special Program of Research, Development, and Research Training in Human Reproduction, Geneva (M.W., T.M.H.N., A.M.G.); Statistika Consultoria, Campinas, Brazil (G.P., J.F.C.); the Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya (A.O., Z.Q.); the Department of Obstetrics and Gynecology, Mother and Child Hospital, Akure (O.O.O.), and the Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan (B.F.) - both in Nigeria; Sriram Chandra Bhanja Medical College, Cuttack (S.M.), S. Nijalingappa Medical College and Hangal Shri Kumareshwar Hospital and Medical Research Center (A.A.M.), Karnatak Lingayat Education Academy of Higher Education and Research, Jawaharlal Nehru Medical College (S.S.G., Y.V.P.), and Shri B.M. Patil Medical College, Hospital and Research Center (S.S.S.), Karnataka, Lata Medical Research Foundation and Daga Women's Hospital, Maharashtra (A.B.P.), and the Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi (U.P.) - all in India; the Institute of Metabolism and Systems Research, University of Birmingham, Birmingham (A.C.), and the Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool (J.N.) - both in the United Kingdom; the Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt (H.A.-A.); the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (P.L.); Centro Rosarino de Estudios Perinatales, Rosario, Argentina (G.C., D.G.); the Effective Care Research Unit, Universities of Witwatersrand-Johannesburg, Fort Hare-Alice, and Walter Sisulu-Eastern Cape, and the Eastern Cape Department of Health, Eastern Cape - all in South Africa (G.J.H.); the Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (L.L.S.); and the Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda (K.M., J.B.).
WHO CHAMPION Trial Group
Centro Rosarino de Estudios Perinatales · ARJawaharlal Nehru Medical College · INMakerere University · UGUnited Nations Children's Fund Niger · NEUniversity of Nairobi · KEAssiut University · EGInstitute of Medical Sciences · INKhon Kaen University · THMother Hospital · INNational University of Singapore · SGShri BM Patil Medical College · INS Nijalingappa Medical College and HSK Hospital & Research Centre · INSriram Chandra Bhanja Medical College Hospital · INUnited Nations Children's Fund India · INUniversity of Birmingham · GBUniversity of Ibadan · NGUniversity of Liverpool · GBWestern Cape Department of Health · ZAWomen's Hospital · US

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundPostpartum hemorrhage is the most common cause of maternal death. Oxytocin is the standard therapy for the prevention of postpartum hemorrhage, but it requires cold storage, which is not available in many countries. In a large trial, we compared a novel formulation of heat-stable carbetocin with oxytocin.

methodsWe enrolled women across 23 sites in 10 countries in a randomized, double-blind, noninferiority trial comparing intramuscular injections of heat-stable carbetocin (at a dose of 100 μg) with oxytocin (at a dose of 10 IU) administered immediately after vaginal birth. Both drugs were kept in cold storage (2 to 8°C) to maintain double-blinding. There were two primary outcomes: the proportion of women with blood loss of at least 500 ml or the use of additional uterotonic agents, and the proportion of women with blood loss of at least 1000 ml. The noninferiority margins for the relative risks of these outcomes were 1.16 and 1.23, respectively.

resultsA total of 29,645 women underwent randomization. The frequency of blood loss of at least 500 ml or the use of additional uterotonic agents was 14.5% in the carbetocin group and 14.4% in the oxytocin group (relative risk, 1.01; 95% confidence interval [CI], 0.95 to 1.06), a finding that was consistent with noninferiority. The frequency of blood loss of at least 1000 ml was 1.51% in the carbetocin group and 1.45% in the oxytocin group (relative risk, 1.04; 95% CI, 0.87 to 1.25), with the confidence interval crossing the margin of noninferiority. The use of additional uterotonic agents, interventions to stop bleeding, and adverse effects did not differ significantly between the two groups.

conclusionsHeat-stable carbetocin was noninferior to oxytocin for the prevention of blood loss of at least 500 ml or the use of additional uterotonic agents. Noninferiority was not shown for the outcome of blood loss of at least 1000 ml; low event rates for this outcome reduced the power of the trial. (Funded by Merck Sharpe & Dohme; CHAMPION Australian New Zealand Clinical Trials Registry number, ACTRN12614000870651 ; EudraCT number, 2014-004445-26 ; and Clinical Trials Registry-India number, CTRI/2016/05/006969 .).

Indexed as

AdultDouble-Blind MethodDrug StabilityFemaleHumansInjections, IntramuscularOxytocicsOxytocinPostpartum HemorrhagePregnancyRiskYoung AdultcarbetocinOxytocicsOxytocin

Identifiers

PMID29949473
OpenAlexW2811495257

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