Comparative Study between Intravenous Bolus Dose of Carbetocin Versus Oxytocin during Cesarean Delivery in Healthy Parturients on Blood Loss: A Randomized Control Trial

Background: Postpartum hemorrhage is a potentially life-threatening complication of both vaginal and cesarean delivery. The most frequent cause of postpartum hemorrhage is uterine atony, therefore, active management of the third stage of labor rather than expectant management is recommended. Oxytocin is the first choice drug for enhancing uterine contraction after delivery. Oxytocin has a short half-life, whereas carbetocin, exerting its effect via the same molecular mechanisms as oxytocin, has a longer half-life, and has been reported to decrease the use of additional oxytocics. The Aim of Study: Is to compare between the effect of carbetocin versus oxytocin given as intravenous bolus to healthy pregnant women undergoing elective cesarean section as regards hemoglobin concentration after cesarean section. Patients and Methods: One hundred seventy two patients undergoing elective cesarean section at term were randomized to two groups receiving either 5IU oxytocin or 100μg carbetocin, complete blood count was done twice, just before and 24 hours after delivery, after delivery of the placenta, the volume of blood loss was assessed. Results: A significant difference was found between both groups as regards blood loss (434.71 Vs 366.48ml in oxytocin and carbetocin group respectively, p=0.013). There was a negative significant correlation between hemoglobin change level and blood loss among oxytocin group (r=–0.277, p=0.01), this correlation was non significant among carbetocin group (r=–0.179, p=0.096). The hemodynamic data is reassuring with no clinically significant differences between the two interventions. Conclusion: Carbetocin appears to be as effective as oxytocin for prevention of postpartum hemorrhage.