Abstract:
Background: Postpartum hemorrhage (PPH) is a leading cause of maternal mortality, particularly in developing countries. Active management of the third stage of labor with uterotonic agents is critical in reducing PPH incidence. This study compared the efficacy and safety of carbetocin, a synthetic oxytocin analogue, to oxytocin in preventing PPH among term pregnancies in a tertiary care hospital in Gujarat, India.
Methods: A prospective randomized controlled trial was conducted over 12 months, enrolling 80 women with singleton term pregnancies. Participants were randomly assigned to receive either 100 mcg of carbetocin intravenously (Group A) or 10 IU of oxytocin intramuscularly (Group B) following delivery. Primary outcomes included estimated blood loss, hemoglobin decline, uterine tone, and requirement for additional uterotonics or blood transfusions. Adverse effects were also recorded.
Results: The carbetocin group demonstrated significantly lower mean blood loss (567.7±160.9 ml vs. 625.5±122.4 ml, P=0.003) and hemoglobin decline at 48 hours post-delivery (10.5±0.9 g/dl vs. 9.8±1.2 g/dl, P=0.002). Fewer participants in the carbetocin group required additional uterotonics (10% vs. 25%, P=0.047) or blood transfusions (7.5% vs. 25%, P=0.034). Both groups exhibited comparable safety profiles.
Conclusion: Carbetocin significantly reduces blood loss and improves clinical outcomes compared to oxytocin, with similar safety, suggesting its potential as a preferred uterotonic agent in resource-limited settings.
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