Carbetocin versus oxytocin for prevention of postpartum hemorrhage in hypertensive women undergoing elective cesarean section

Objective: Assess the efficacy and safety of carbetocin, versus oxytocin in the prevention of postpartum hemorrhage in hypertensive women.

Study design: A randomized clinical trial.

Setting: Obstetrics and Gynecology Department of Suez Canal University Hospital.

Patients: One hundred and sixty hypertensive pregnant women who underwent CS.

Interventions: Patients were randomized to receive either 10 IU oxytocin or 100 μg carbetocin. Primary outcomes included estimated blood loss, blood transfusion, hemoglobin (HB), and hematocrit changes pre- and post-delivery and the use of additional uterotonics.

Results: The postoperative HB was not different from preoperative HB in the carbetocin group (11.8 ± 1.2 vs. 11.2 ± 1.2 g/dL) while it decreased significantly in the oxytocin group (12.1 ± 3.8 vs. 10.4 ± 1.1 g/dL, p < 0.001). Blood loss was significantly more among the oxytocin group (679.5 ± 200.25 vs. 424.75 ± 182.59 ml) in the carbetocin group (p < 0.001). Nausea, vomiting, and sweating were reported more significantly in oxytocin group patients.

Conclusion: Carbetocin was more effective than oxytocin in reducing intraoperative and postoperative blood loss.

Keywords: Postpartum hemorrhage; carbetocin; elective cesarean section; oxytocin.