Abstract: Introduction: Postpartum hemorrhage is a common cause of maternal mortality all over the world and its incidence is increasing day by day.
Objective: To compare the efficacy of single dose of 100 ?g Intravenous Carbetocin to single dose of 10 Unit Intravenous Oxytocin in reducing incidence and severity of Postpartum Hemorrhage in women at risk. Material and Methods: This study was conducted in the Department of Obstetrics and Gynecology, ESIC Medical College and Hospital, Faridabad, Haryana (India). A total of 128 women who underwent delivery were enrolled with various risk factors for primary post-partum hemorrhage.
Results: A total of 128 patients enrolled were divided into 64 patients in each group. The mean age of mothers of study group was 28.18+4.25 years and in control group was 29.12+4.19 years. The average gestational age was 37.6 weeks in study group and 38 weeks in control group. Multigravida women was 43(67.19%) in study group and 41(64.06%) in control group. A total of 53.13% cases in study and 56.25% cases in control group underwent LSCS and 45.31% cases in study group and 43.75% cases in control group underwent vaginal delivery. Mean birth weight in study group was 2.53 kg and in control group was 2.69 kg. Mean blood loss in study group was 428.11+336.24ml and in Control group was 587.2+437.15ml. Mean fall in hemoglobin in study group was 0.45+0.32gm/dl and in control group was 0.71+0.37gm/dl i.e. statistically significant. 14.06% of cases in study group and 29.68% of cases in control group needed additional uterotonic other than assigned uterotonics that was statistically significant. Mean urine output in study group was 1217.26+413.34ml and in control group was 1036.28+362.16ml. Significant difference according to additional uterotonic requirement, The mean fall in hemoglobin in the study group was 0.52 ±0.36 gm/dL compared to 0.81±0.47 gm/dL in the control group, indicating a statistically significant difference (p = 0.06). The mean fall in hemoglobin in the study group was 0.52 ±0.36 gm/dL compared to 0.81±0.47 gm/dL in the control group, indicating a statistically significant difference. Greater fall in hemoglobin was observed in the oxytocin group (p = 0.06). Sustained contraction by carbetocin showed maximum number of patient in study group had abdominal pain i.e. 16.89% cases and 14.16% in control group had abdominal pain after giving uterotonic.
Conclusion: The present study concluded that intravenous Carbetocin as compared to intravenous Oxytocin in reducing postpartum blood loss, postpartum anemia, incidence of atonic postpartum haemorrhage found to be effective. Requirement of additional uterotonic, and blood transfusion in high risk pregnancy. Single dose of Carbetocin appears to be more effective than single dose of oxytocin to prevent the Postpartum Haemorrhage, with similar hemodynamic profile and minor antidiuretic effect.
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