Carbetocin versus oxytocin and ergometrine for prevention of postpartum hemorrhage following caesarean section

Abstract

Objective: To compare the effectiveness of carbetocin versus oxytocin and ergometrine when administered after caesarean section for prevention of postpartum hemorrhage (PPH).Patients and Methods: A prospective randomized observational study in the year 2014 was conducted on 200 women at term undergoing elective cesarean section under regional anesthesia. Women with pre term gestational age, diabetes, hypertension and coronary heart disease were excluded. Women were put into two groups : One group containing 100 women received I.V. carbetocin 100 microgram, while the other group which also contained 100 women received a combination of I.V. oxytocin 5 IU and I.M. Ergometrine 0.2mg after the delivery of the baby. The primary outcome measure: 1-Uterine tone and size were assessed by resting a hand on the fundus of uterus and palpating anterior wall of the uterus one hour after delivery, the presence of boggy uterus with either heavy vaginal bleeding or increasing uterine size is suspicious for uterine atony ; 2- Need of additional oxytocics. Secondary outcome measure: Blood loss and hemoglobin concentration were estimated.Results: There was a significant difference between both groups as regards uterine atony and need for additional oxytocics after delivery. On the other side, there was no significant association between both study groups as regards vaginal bleeding or HB estimation before and after operation or HB difference.Conclusion: Carbetocin is more potent long acting oxytocic with less need for other additional uterotonic drugs and less occurrence of uterine atony.