Carbetocin Compared with Oxytocin in Prevention of Postpartum Hemorrhage in Cases of Uterine Overdistention

Postpartum haemorrhage is defined as blood loss of one thousand millilitres or hypovolemia. It may result from uterine atony, retained placental tissue, maternal genital tract trauma and accidental haemorrhage. Separation of the placenta, uterine contraction, and typical hemostatic mechanisms regulate normal postpartum bleeding. Oxytocin is the best in preventing postpartum haemorrhage. Carbetocin, a long-acting synthetic analogue of oxytocin with agonist action, is injected intravenously as a single bolus over 1 minute to prevent postpartum haemorrhage and decrease the need for further uterotonic medications. The aim of this study is to compare the effectiveness, safety, and tolerability of carbetocin versus oxytocin in prevention of postpartum hemorrhage. This is a prospective clinical trial include 100 pregnant women divided into 2 equal groups in the department of obstetrics and gynecology at Itay Al-Baroud General Hospital. Group (A): Received 100 mcg of carbetocin as a single dose by direct intravenous injection over one minute. Group (B): The women received a continuous intravenous infusion of 10 IU oxytocin in 500 ml 0.9% NaCl solution. The difference was statistically non-significant according to total blood loss. Regarding the need for additional uterotonics drugs and blood transfusion the difference was significantly higher in Oxytocin group. According to the adverse effects of both drugs there was no significant difference between groups except for Pyrexia which was significantly higher in Oxytocin group and Nausea significantly higher in Carbetocin group. Complete blood count data 24 hours after delivery was significantly better in Carbetocin group. women having carbetocin had higher hemoglobin, less blood loss, reduced need for additional uterotonics, and reduced need for blood transfusion.