Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Carbetocin at Elective Cesarean Delivery: A Dose Finding Study (Part 2)
Brief Summary: Post-partum hemorrhage (PPH) is a major cause of maternal death worldwide. Oxytocin is the most common uterotonic drug used to prevent and treat PPH in North America, however, there are some limitations to its use. Oxytocin has a very short duration of action, which requires a continuous infusion to achieve sustained uterotonic activity. The Society of Obstetricians and Gynecologists of Canada (SOGC) has recently recommended a single 100mcg dose of carbetocin at elective Cesarean delivery to promote uterine contraction and prevent post partum hemorrhage (PPH), in lieu of the more traditional oxytocin regimens. Carbetocin lasts 4 to 7 times longer than oxytocin, with a similar side effect profile and apparent greater efficacy rate. However, a dose response to determine the minimum effective dose of carbetocin has not yet been published. The investigators hypothesize that the minimum effective dose (ED90) is above 20mcgs and below 80mcgs in women undergoing elective Cesarean delivery.


Options:
A: Arm Label: Oxytocin 10 units/500cc; Type: ACTIVE_COMPARATOR; Interventions: Drug: Oxytocin | Arm Label: Oxytocin 40 units/500cc; Type: EXPERIMENTAL; Interventions: Drug: Oxytocin | Arm Label: Oxytocin 80U/500cc; Type: EXPERIMENTAL; Interventions: Drug: Oxytocin | Intervention Type: DRUG; Name: Oxytocin; Assigned to Arm(s): Oxytocin 10 units/500cc, Oxytocin 40 units/500cc, Oxytocin 80U/500cc
B: Arm Label: intravenous & intramuscular oxytocin; Type: EXPERIMENTAL; Interventions: Procedure: after delivery of the fetus & when anterior shoulder seen | Arm Label: after delivery & when anterior shoulder seen; Type: ACTIVE_COMPARATOR; Interventions: Drug: intravenous & intramuscular oxytocin | Intervention Type: DRUG; Name: intravenous & intramuscular oxytocin; Assigned to Arm(s): after delivery & when anterior shoulder seen | Intervention Type: PROCEDURE; Name: after delivery of the fetus & when anterior shoulder seen; Assigned to Arm(s): intravenous & intramuscular oxytocin
C: Arm Label: Arm A: sublingual misoprostol 600µg; Type: EXPERIMENTAL; Interventions: Drug: Misoprostol | Arm Label: Arm B: 10 IU Oxytocin; Type: PLACEBO_COMPARATOR; Interventions: N/A | Intervention Type: DRUG; Name: Misoprostol; Assigned to Arm(s): Arm A: sublingual misoprostol 600µg
D: Arm Label: Carbetocin 20mcg; Type: ACTIVE_COMPARATOR; Interventions: Drug: Carbetocin | Arm Label: Carbetocin 40mcg; Type: ACTIVE_COMPARATOR; Interventions: Drug: Carbetocin | Arm Label: Carbetocin 60mcg; Type: ACTIVE_COMPARATOR; Interventions: Drug: Carbetocin | Arm Label: Carbetocin 80mcg; Type: ACTIVE_COMPARATOR; Interventions: Drug: Carbetocin | Arm Label: Carbetocin 100mcg; Type: ACTIVE_COMPARATOR; Interventions: Drug: Carbetocin | Intervention Type: DRUG; Name: Carbetocin; Assigned to Arm(s): Carbetocin 20mcg | Intervention Type: DRUG; Name: Carbetocin; Assigned to Arm(s): Carbetocin 40mcg | Intervention Type: DRUG; Name: Carbetocin; Assigned to Arm(s): Carbetocin 60mcg | Intervention Type: DRUG; Name: Carbetocin; Assigned to Arm(s): Carbetocin 80mcg | Intervention Type: DRUG; Name: Carbetocin; Assigned to Arm(s): Carbetocin 100mcg

Answer: D