Carbetocin in comparison with oxytocin in caesarean section

الملخص EN

Objective : To compare the effectiveness of carbetocin and oxytocin during caesarean section for prevention of postpartum haemorrhage.

Patients and Methods : In this prospective randomized clinical trial, 64 women undergoing caesarean section were randomly allocated into two equal groups to receive a slow intravenous injection (over 90 seconds) of a single dose of carbetocin 100 ug (carbetocin group) or oxytocin 5IU (Oxytocin group) after clamping of the umbilical cord immediately after delivery.

The amount of intraoperative and postoperative blood loss, need for blood transfusion, need for an additional uterotonic and postoperative haemoglobin concentration were recorded.

Results : Blood loss was significantly lower in carbetocin group (465  64 ml) than in oxytocin group (666  68 ml ; P < 0.001).

Postoperative haemoglobin concentration was significantly higher in the carbetocin group than in the oxytocin group (10.3  0.5 gm / dl vs 9.7  0.7 gm /dl, respectively ; P < 0.001).

Additional uterotonics were required in oxytocin group only, while were not required in carbetocin group (6[18.75 %] vs 0 [0.0 %], respectively ; P = 0.032).

Only one patient in oxytocin group required blood transfusion, with a non–significant difference (P = 1.0).

Side effects were developed in 15 (23.44 %), patients with a non significant lower difference in carbetocin group (6[18.75] vs 9[28.13], respectively ; P = 0.55).

Conclusion : Compared to oxytocin during caesarean section, carbetocin is associated with a reduced blood loss, a lesser need for additional uterotonics and comparable minimal drug–related side effects.