Evaluation of carbetocin and oxytocin efficacy in prevention of postpartum hemorrhage in women after cesarean section

Introduction: Postpartum hemorrhage (PPH) constitutes the main cause of delivery-related maternal mortality worldwide. Identification of the risk factors, as well as knowledge about preventive measures and adequate management, allow to limit blood loss. Oxytocin, carbetocin, methylergometrine, dinoprostone, sulprostone, and misoprostol are commonly used drugs in prevention of PPH. Objectives: The aim of the study was to evaluate the efficacy of carbetocin and oxytocin in prevention of PPH after cesarean section. Material and methods: The study included 130 female patients after C-section who received 100 pg of carbetocin i.v. as a preventive agent after the surgery The control group consisted of 60 women who received 10 units of oxytocin i.v In the study the risk factors for PPH were determined, and hemoglobin and hematocrit values before and 12 hours afterbirth, as well as blood loss and the need to use other preventive and operational methods were evaluated. Results were compared between the groups. Statistical analysis was performed with the use of Statistica for hemoglobin and hematocrit values. The p-value of <= 0.05 was considered as statistically significant. Results: Risk factors for PPH occurred in almost 100% of the women with carbetocin and in 90% of the women with oxytocin. The decrease in hemoglobin and hematocrit levels was not statistically significant, although a greater drop was detected in the group with oxytocin (hemoglobin - 1.24 vs. 1.17 g%, hematocrit - 3.26 vs. 2.93%). The decrease in hematological values was not statistically significant between both groups. In the group with carbetocin, there was no need for additional pharmacological therapy or operative procedures. No adverse events in either of the groups were observed. Conclusions: 1. Carbetocin effectively prevents PPH after C-section. 2. Carbetocin seems to have high efficiency in PPH prevention in pregnant women classified to the PPH risk group. 3. Efficacy of Carbetocin in PPH prevention is higher than oxytocin.