Carbetocin- A Promising Alternative to Oxytocin for Prevention of Postpartum Hemorrhage in Elective Cesarean Section in High-Risk Women

Abstract Introduction: Postpartum hemorrhage (PPH) is a leading cause of maternal mortality, responsible for approximately 140,000 deaths annually, with significant morbidity associated with blood transfusions and extended hospital stays. Effective management strategies are critical, particularly during cesarean sections, which are recognized as significant risk factors for PPH. Objective: This study aims to evaluate the efficacy and safety of carbetocin compared to oxytocin in preventing PPH among high-risk women undergoing elective cesarean sections. Methods: A prospective comparative analysis was conducted at SMS Medical College, Jaipur, from November 2022. Pregnant women at term with high-risk factors for PPH were included, while those with specific medical conditions were excluded. A total of 100 patients were randomly assigned in two groups. Group 1 receives 100 μg carbetocin intravenously while group 2 receives 10 IU oxytocin intramuscularly after delivery. Pre-operative and post-operative parameters, including blood pressure, pulse rate, and hemoglobin levels, were monitored and statistically analyzed. Results: The study population predominantly comprised women aged 26-30 years, with no significant differences in baseline characteristics between the carbetocin and oxytocin groups. Both groups exhibited similar trends in blood pressure and pulse rate post-administration. Notably, carbetocin demonstrated a lower incidence of PPH and reduced overall blood loss compared to oxytocin. Conclusion: Carbetocin, with a quicker onset, longer action, and better stability, proved more effective, leading to less blood loss, fewer PPH cases, and reduced need for additional uterotonics. Its safety profile is comparable to oxytocin, making it a promising alternative for PPH prevention and improved maternal outcomes.