Comparison of carbetocin and oxytocin in the prevention of atonic post-partum hemorrhage following normal vaginal delivery

Background: Post-partum hemorrhage is the leading cause of maternal mortality worldwide. Use of uterotonic drugs in active management of third stage of labour has been found to be most effective in prevention of PPH.  Aims and objectives were to compare the efficacy and safety of carbitocin and oxytocin for prophylaxis of post-partum hemorrhage after singleton, term vaginal deliveries.Methods: Prospective randomized interventional study of 250 women with singleton term pregnancies undergoing vaginal delivery at MGM Women and Children’s Hospital, Kalamboli from May 2021 to May 2022. Participants randomized into 2 groups, group A and B receiving carbitocin and oxytocin respectively. Post-delivery uterine tone, vaginal bleeding, change in Hb and PCV, occurrence of adverse effects used to assess efficacy and safety of both drugs.Results: Carbetocin was statistically equal to oxytocin in preventing uterine atony and hence PPH, with similar duration of uterotonic action and lesser requirement of other uterotonic drugs. There was no incidence of adverse effects in either group.Conclusions: Since carbetocin is an effective, room temperature stable uterotonic drug with minimal side effects, it can be beneficial for use in prevention of PPH in rural settings

The pace of vocabulary growth during preschool predicts cortical structure at school age

Children vary greatly in their vocabulary development during preschool years. Importantly, the pace of this early vocabulary growth predicts vocabulary size at school entrance. Despite its importance for later academic success, not much is known about the relation between individual differences in early vocabulary development and later brain structure and function. Here we examined the association between vocabulary growth in children, as estimated from longitudinal measurements from 14 to 58 months, and individual differences in brain structure measured in 3(rd) and 4(th) grade (8–10 years old). Our results show that the pace of vocabulary growth uniquely predicts cortical thickness in the left supramarginal gyrus. Probabilistic tractography revealed that this region is directly connected to the inferior frontal gyrus (pars opercularis) and the ventral premotor cortex, via what is most probably the superior longitudinal fasciculus III. Our findings demonstrate, for the first time, the relation between the pace of vocabulary learning in children and a specific change in the structure of the cerebral cortex, specifically, cortical thickness in the left supramarginal gyrus. They also highlight the fact that differences in the pace of vocabulary growth are associated with the dorsal language stream, which is thought to support speech perception and articulation