Carbetocin versus oxytocin for the prevention of postpartum haemorrhage during caesarean section in patients at high risk of bleeding

Objective: To evaluate the efficacy of carbetocin versus oxytocin in preventing postpartum haemorrhage (PPH) in women with risk factors for PPH who were delived by caesarean section. Methods: This retrospective, monocentric, before-and-after cohort study assessed patients with haemorrhagic risk factors who underwent caesarean section after 24 weeks of gestation and who had haemorrhagic risk factors between August 2014 to December 2019. Results: This study enrolled 518 patients, including 250 in the oxytocin group and 268 in the carbetocin group. The use of carbetocin was independently associated with a PPH decrease compared to oxytocin use (adjusted odds ratio [OR]: 0.52; 95 % confidence interval [CI]: 0.35-0.79; p = 0.002). Carbetocin use was associated with a reduction in the need for therapy escalation (6 % vs 10.8 %; p = 0.046). Conclusion: Carbetocin was more effective than oxytocin in preventing PPH after caesarean section in high-risk patients.