Publication:

Comparative efficacy of carbetocin versus oxytocin in preventing postpartum hemorrhage during lower segment cesarean section: a prospective randomized controlled trial

Background This study was conducted to compare the efficacy of a single-dose carbetocin with oxytocin infusion in preventing postpartum hemorrhage (PPH) during lower segment cesarean section (LSCS).

Methods A prospective randomized controlled trial was conducted on 120 pregnant women undergoing elective or emergency LSCS at a tertiary care hospital in the state of Maharashtra. The study participants were randomly assigned to receive either a single intravenous dose of 100 μg carbetocin (n=60) or 20 IU oxytocin infusion (n=60) after delivery of the baby. The primary outcome assessed was the incidence of PPH (blood loss ≥1000 ml) whereas the secondary outcomes included mean blood loss, need for additional uterotonics and blood transfusion requirements.

Results The incidence of PPH was significantly lower in the carbetocin group (3.3%) compared to the oxytocin group (15.0%) (p=0.026). The mean blood loss was 435.2±152.8 ml in the carbetocin group versus 624.7±218.4 ml in the oxytocin group (p<0.001). Additional uterotonics were required in 5% of patients in the carbetocin group versus 18.3% in the oxytocin group (p=0.021). Blood transfusion was needed in 1.7% of women in the carbetocin group compared to 8.3% in the oxytocin group (p=0.048).

Conclusions A single-dose carbetocin is more effective than oxytocin infusion in preventing PPH during LSCS, with reduced requirement for additional uterotonics and blood transfusions.