Efficacy of Intravenous Carbetocin vs Intravenous Oxytocin in Active Management of Third Stage of Labor in Women Delivering Vaginally: A Randomized Controlled Trial

Background: Postpartum hemorrhage (PPH) often leads to maternal morbidity and mortality globally.Active management of the third stage of labor (AMTSL) plays a crucial role in PPH prevention.Oxytocin is the standard uterotonic agent used for AMTSL, but its short half-life and heat instability limit its effectiveness in low-resource settings.Carbetocin, a long-acting and heat-stable oxytocin analog, offers potential advantages in preventing PPH.This study aimed to compare the efficacy of intravenous carbetocin vs intravenous oxytocin in the AMTSL among women delivering vaginally.Methodology: A randomized controlled trial was conducted in a tertiary care hospital, involving 184 antenatal women.The women were enrolled in group A (100 g of intravenous carbetocin) and group B (10 IU of intravenous oxytocin right after the delivery of the baby).The outcome measures assessed consisted of fetomaternal parameters following the descriptive and inferential statistical analysis.Results: The quantity of blood loss, need for blood transfusion, hemoglobin level drop after 72 hours, and neonatal intensive care unit (NICU) admission of the neonates were less in the carbetocin group, with the majority of the women undergoing normal vaginal deliveries.Also, the carbetocin group presented more need for additional uterotonics.Conclusion: Intravenous carbetocin is found to be more effective than intravenous oxytocin in reducing the amount of blood loss and the need for blood transfusions during the AMTSL in vaginal deliveries.Carbetocin's heat stability and prolonged action make it a promising alternative in low-resource settings.