Comparison of Hemodynamic and Uterotonic Effects of Carbetocin and Oxytocin in Cesarean Section with High Risk of Postpartum Hemorrhage (Code-T0115)

Introduction: Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality, particularly in cesarean sections with high-risk factors. Oxytocin is commonly used to prevent uterine atony and control bleeding, but its hemodynamic effects may sometimes lead to complications. Carbetocin, a long-acting synthetic analogue of oxytocin, is being explored as an alternative due to its potential for fewer side effects. This study compares the hemodynamic and uterotonic effects of carbetocin and oxytocin in cesarean sections at high risk for postpartum hemorrhage.

Aims and Objectives: This study was carried out within the Department of Obstetrics and Gynaecology at L.L.R.M. Medical College and its associated S.V.B.P. Hospital in Meerut, spanning the periods from October 2022 to March 2024, for duration of 18 months with the following aims and objectives. 

• To assess the efficacy of Carbetocin in terms of intra-operative blood loss and the additional uterotonic needed in caesarean section at high risk of post-partum hemorrhage.
• To compare the safety and hemodynamic effects of carbetocin versus oxytocin infusion in prevention of PPH in high-risk women undergoing Cesarean section.

Methods: A prospective, randomized controlled trial was conducted with 120 pregnant women undergoing cesarean section at high risk for PPH. Participants were randomly assigned to receive either carbetocin (100 µg) or oxytocin (10 IU). The primary outcomes measured were the uterine tone, incidence of PPH, and the hemodynamic parameters, including blood pressure and heart rate, during and after administration.

Results: The carbetocin group showed a more stable hemodynamic profile compared to the oxytocin group, with less fluctuation in blood pressure and heart rate. Uterine tone was better maintained in the carbetocin group, with a lower incidence of PPH.

Conclusion: Carbetocin demonstrated superior uterotonic effects and more stable hemodynamics than oxytocin in cesarean sections at high risk for postpartum hemorrhage. It may be a preferred option for managing these high-risk patients.

Keywords: Carbetocin, Oxytocin, Postpartum Hemorrhage, Cesarean Section, Hemodynamics, Uterotonic.