Comparison the Effect of Carbetocin and Oxytocin for Prevention of Postpartum Hemorrhage at Cesarean Section

Background:Postpartum hemorrhage is one of the major causes of maternal mortality. Carbetocin is a long-term oxytocin analogue. A single dose of carbetocin acts at a rate of sixteen hours of intravenous oxytocin injection and increases the tone of the uterus and reduces the risk of postpartum hemorrhage. So far, many clinical trials have been conducted to compare the efficacy of carbetocin and oxytocin. In a review conducted in 2013, it showed that carbetocin had equal, even better efficacy than oxytocin in normal vaginal delivery, but findings about cesarean section did not confirm the superiority of carbetocin. This study aimed to comparison the effect of Carbetocin and Oxytocin for prevention of postpartum hemorrhage at cesarean section.Methods: In this clinical trial, 48 women undergoing first or second caesarean section were performed with spinal anesthesia in Ali-Ibne-Abitaleb hospital Zahedan in 2014,2015 years. Pregnant women were randomly divided in the Carbetocin 50 microgram and 24 hours’ infusion Oxytocin groups. hemoglobin, uterine tonicity and postoperative complications were measured. Data using t-test and chi-square tests were evaluated.Results: Mean gestational age of patients was 37.4±2.8 weeks. Gravity was 2.7±1.6, respectively. 28 patients (58.3%) had a history of previous cesarean section. Most reason of cesarean section, respectively repeat cesarean (60.4), meconium (20.8) and breech (16.7). Mean Hb before, 6 and 12 hours after cesarean section in Carbetocin group was 12.5±1.0, 11.8±1.1 and 11.3±0.9 respectively. (P=0.001) in oxytocin group was 12.6±1.5, 11.6±1.7 11.2±1.8, respectively. (P=0.001) the need for other uterotonic drugs in Carbetocin group was 20.8% and in oxytocin group was 25%. (P=0.731) In this study, the uterine tonisity and fundal height was normal and in all patients between the two groups was not observed complications. (P<0.05)Conclusions: The study findings suggest that Carbetocin and oxytocin the same effective in reducing postpartum hemorrhage and complications and need for other uterotonic agent is similar

Keywords:

Oxytocin , Carbetocin , Postpartum hemorrhage , cesarean section