Comparison of Carbetocin and Oxytocin for the Prevention of PostpartumHemorrhage in Cesarean Section: A Prospective Study (Code-T0304)

Introduction: Postpartum Hemorrhage (PPH) is the leading cause of maternal mortality
worldwide, with uterine atony being the primary cause. The World Health Organization (WHO)
recommends active management of the third stage of labor to prevent PPH, with the
administration of uterotonic agents being the most crucial component. This practice has resulted
in a nearly 50% reduction in PPH incidence. Oxytocin is the first-line drug for PPH prophylaxis.
Aim: To compare the efficacy of Carbetocin with Oxytocin in the prevention of Postpartum
Hemorrhage (PPH) during Cesarean Section.
Objectives
 To evaluate the effectiveness of Carbetocin in preventing PPH during Cesarean Section.
 To compare the efficacy of Carbetocin and Oxytocin in PPH prevention.
 To assess and compare the hemodynamic effects of Carbetocin and Oxytocin.
Methods: This study included 220 women undergoing cesarean section, divided into two equal
groups (n=110). Group A (Carbetocin group): Received a single intravenous bolus dose of 100
μg Carbetocin diluted in 10 mL of normal saline. Group B (Oxytocin group): Received an
intravenous infusion of 20 IU Oxytocin in 1000 mL of 0.9% NaCl solution at a rate of 150
mL/hour post-delivery.
The study assessed mean blood loss, changes in hemoglobin and hematocrit levels, need for
additional uterotonics, blood transfusions, hemodynamic changes, and side effects.
Results: Carbetocin was more effective in preventing PPH than Oxytocin. Mean blood loss:
346.4 mL in Group A vs. 426.7 mL in Group B (statistically significant, p<0.001). A greater
proportion of women in the Oxytocin group required additional uterotonics and blood
transfusions, though the difference was not statistically significant (p>0.05). Hemoglobin
decline: 0.78±0.3 g/dL in Group A vs. 1.65±0.5 g/dL in Group B (significant difference).
Hematocrit reduction: 2.45±1.22% in Gsroup A vs. 2.85±1.35% in Group B (significant
difference). Hemodynamic effects and side effects were comparable between both groups.
Conclusion: A single injection of Carbetocin is more effective than an Oxytocin infusion in
preventing PPH during cesarean section. Carbetocin was associated with lower blood loss,
reduced need for additional uterotonics and transfusions, while exhibiting a similar
hemodynamic profile and side effect profile to Oxytocin.