Comparative Study of Oxytocin and Carbetocin in the Prevention of Postpartum Hemorrhage Following Cesarean Section (Code -T0357)

Introduction: Postpartum hemorrhage (PPH) remains a major cause of maternal mortality 
worldwide. Oxytocin is the standard uterotonic used for PPH prevention, but carbetocin, a 
long-acting oxytocin analogue, has shown potential as a superior alternative. This study 
compares the efficacy of oxytocin and carbetocin in preventing PPH following caesarean 
section. 
Aims and Objectives: 
1. To compare the hemodynamic effects of Oxytocin and Carbetocin  
2. To assess the efficacy of these two drugs in terms of intra-operative blood loss and the 
additional Uterotonics needed in caesarean section at high risk of post-partum 
hemorrhage.  
Methods: A prospective case-control study was conducted in the Department of Obstetrics 
and Gynaecology at Rajarajeswari Medical College and Hospital from April 2023 to April 
2024. A total of 100 pregnant women undergoing caesarean section were randomly assigned 
to two groups: Group A received 100 mcg intravenous carbetocin, while Group B received 20 
IU of oxytocin. The primary outcomes measured included the incidence of PPH, estimated 
blood loss, need for additional uterotonics, and postoperative hemoglobin levels. 
Results: The mean estimated blood loss was 524 mL in the carbetocin group and 706 mL in 
the oxytocin group (p < 0.05). Additional uterotonics were required in 36% of carbetocin 
recipients compared to 72% in the oxytocin group. The incidence of PPH was significantly 
lower in the carbetocin group. 
Conclusion: Carbetocin demonstrated superior efficacy in reducing blood loss, maintaining 
uterine tone, and decreasing the need for additional uterotonics. It serves as a promising 
alternative to oxytocin for PPH prevention after caesarean section. 
Keywords: Postpartum Hemorrhage, Carbetocin, Oxytocin, Caesarean Section, Uterotonics, 
Maternal Health.