Management of Accidental Preincisional Administration of Carbetocin in Cesarean Delivery

Br J Anaesth. 2026 Mar: 136(3):1059–1061 doi: 10.1016/j.bja.2025.12.012 Uterine atony remains a major contributor to maternal morbidity and mortality worldwide. To reduce the risk of postpartum hemorrhage during cesarean delivery (CD), uterotonic agents such as oxytocin receptor agonists are routinely administered after clamping of the umbilical cord to promote sustained uterine contraction. Carbetocin, a long-acting oxytocin analogue, has been shown to be at least as effective as oxytocin and is increasingly recommended for this purpose. This correspondence describes a case in which carbetocin was unintentionally administered before neuraxial anesthesia and prior to delivery because of a medication substitution error.