Carbetocin versus oxytocin in the management of the third stage of labor for preventing postpartum hemorrhage after vaginal delivery

TL;DR

This study compares carbetocin and oxytocin for preventing heavy bleeding after vaginal delivery and finds both drugs equally effective and safe.

Contribution

The study provides evidence that carbetocin is as effective as oxytocin in preventing postpartum hemorrhage in high-risk women.

Findings

Carbetocin and oxytocin showed similar effectiveness in reducing postpartum blood loss.

No significant difference was found in hemoglobin levels or need for additional uterotonics between the two drugs.

Abstract

The aim of this study was to compare the effect of carbetocin and oxytocin administration on the prevention of postpartum hemorrhage concerning the estimated amount of bleeding, the need for additional uterotonics, and alterations in hemoglobin levels in patients undergoing vaginal delivery.

A cohort investigation was carried out at a tertiary hospital from November 2020 to December 2023, comprising women who underwent vaginal delivery and exhibited at least one risk factor for atonic postpartum hemorrhage. The study included pregnant women at gestational ages between 37 and 40 weeks. Following vaginal delivery, the participants were randomly assigned to receive either five units of oxytocin or 100 μg of carbetocin intravenously. Postpartum blood loss was subsequently measured objectively in milliliters using a calibrated bag attached to a postpartum drape.

The peripartum estimated bleeding volumes for the oxytocin and carbetocin groups were 461.41±65.41 cc and 446.35±68.18 cc, respectively (p=0.096). There was no statistically significant difference observed between the two groups in terms of hemoglobin decrease and additional uterotonic requirement (p=0.904 and p=0.348, respectively).

The findings suggest that carbetocin was equally effective and safe compared to oxytocin in preventing postpartum hemorrhage among women undergoing vaginal delivery.