Carbetocin versus Misoprostol in Reducing Blood Loss during Cesarean Section in low risk patients. A Randomized Controlled Trial

Abstract

Aim: This study aimed to compare the use of misoprostol to carbetocin in reducing blood loss during cesarean section in low risk patients.Materials and Methods: This randomized controlled study enrolled 300 patients who were eligible. 150 women received carbetocin100ug i.v intra-operative immediately after extraction of the fetus during cesarean section (group A). They were compared to 150 women who received misoprostol 600ug rectally immediately before sterilization during caesarean section (group B).Results: There is significant difference in intraoperative uterine atony [3 (2.0%) vs 11 (7.3%) P 0.018] and surgical hemostatic measures as uterine artery ligation and uterine compression sutures [0.00 vs 3.00 (2%) P < 0.00 and 0.00 vs 12.00 (8%) P < 0.00] were higher in misopristol group. Also, the need for other uterotonic drugs was significantly higher in misopristol group (10.0 ± 0.0 vs 13.15 ± 5.28, P < 0.001 and the difference in hemoglobin and hematocrit values before and after delivery were slightly higher in misopristol group with no statistical significance (10.71 ± 0.98 vs 10.86 ± 0.84, P < 0.15 and 33.86 ± 2.8 vs 34.29 ± 2.7, P < 0.17).Conclusion: Intravenous therapy infusion of 100 ug carbetocin reduced but no significantly blood loss during cesarean section than 600ug rectal misoprostol.