Comparison of Oxytocin versus Carbetocin in Vaginal Delivery - A Randomised Controlled Study

Background: Postpartum hemorrhage (PPH) is a leading cause of maternal mortality globally, especially in low - resource settings. Oxytocin is widely used to prevent PPH but has limitations, including its short half - life and need for continuous infusion and refrigeration. Carbetocin, a long - acting synthetic analogue of oxytocin, addresses these issues by offering a longer half - life and stability at room temperature, making it suitable for use in diverse clinical settings. However, data comparing oxytocin and carbetocin in vaginal deliveries is limited. Aim and Objectives: This study aimed to compare the efficacy of intravenous oxytocin (10 IU) versus intravenous carbetocin (100 mcg) in reducing postpartum blood loss and preventing PPH in vaginal deliveries with high - risk factors. Material and Method: A randomized controlled study was conducted at a tertiary care hospital in Rajasthan, India. A total of 120 women with at least one high - risk factor for PPH were randomized into two groups. Group A received 10 IU of oxytocin, and Group B received 100 mcg of carbetocin at delivery. The primary outcome was blood loss during the postpartum period, while secondary outcomes included hemoglobin drop, need for additional uterotonics, and blood transfusion. Results: The average blood loss was significantly lower in the carbetocin group (181.33 mL) compared to the oxytocin group (256.75 mL, p=0.02). The hemoglobin decrease was smaller in the carbetocin group (1.08 g/dL vs.1.34 g/dL, p=0.0001). Fewer patients in the carbetocin group required additional uterotonics (13.33% vs.30%, p=0.046) and blood transfusions (0% vs.10%, p=0.036). Conclusion: Carbetocin is more effective than oxytocin in reducing postpartum blood loss and the need for additional interventions in vaginal deliveries, making it a preferred option for PPH prevention in high - risk cases.