Ex-vivo study to compare oxytocin, ergometrine, carboprost efficacy in carbetocin-desensitized human myometrium

Uterine atony is a primary cause of post-delivery bleeding, a severe obstetric complication. While carbetocin is an effective uterotonic for preventing this, some patients experience persistent bleeding, necessitating additional interventions. Current clinical practice lacks clear evidence on which secondary uterotonic is most effective after initial carbetocin administration has failed. This study aims to address this critical gap by evaluating the comparative efficacy of available uterotonics in a simulated desensitized uterine environment.

This planned ex-vivo study will utilize small samples of human uterine tissue, obtained from the incision site following cesarean section deliveries. In the laboratory, these tissue samples will first be pre-exposed to carbetocin to induce desensitization, mimicking a clinical scenario of initial treatment failure. Subsequently, the desensitized myometrial tissues will be exposed to other common uterotonic drugs: oxytocin, ergometrine, or carboprost. The primary endpoint will be to compare the dose-response profiles of these secondary uterotonics, assessing their ability to induce contraction in the pre-treated tissue.