Comparison of Intravenous Carbetocin and Intramuscular Oxytocin in Preventing Post-Partum HemorrhageDuring Vaginal Delivery

Postpartum hemorrhage (PPH) and its prevention pose significant issues globally that severely affect maternal health. The Active Management of the Third Stage of Labour (AMTSL) is essential for reducing PPH risk.

This study aimed to compare the effectiveness of intravenous carbetocin versus intramuscular oxytocin in managing the third stage of labour during vaginal deliveries.A prospective randomized case-control study was carried out from September 2021 to August 2022 and included 200 women undergoing vaginal delivery. These parturients were split into two equal groups: Group A received a 100 microgram intravenous bolus of carbetocin, while Group B received 10 international units (IU) of intramuscular oxytocin. Outcomes measured included primary PPH, total blood loss, need for additional uterotonics, blood transfusions, and any adverse effects experienced postpartum.

The results demonstrated the following:

• The average blood loss was lower in the carbetocin group compared to the oxytocin group, though this difference was not statistically significant.
• However, significant differences were noted in the incidence of PPH (11% for carbetocin vs. 23% for oxytocin), the need for additional uterotonics (21% vs. 35%), and the mean decrease in hemoglobin levels.
• The incidence of side effectswas similar in both groups.

Thus, the study concluded that carbetocin demonstrated greater effectiveness than oxytocin in preventing PPH during vaginal deliveries.

Source: Tai K, Barman K, Das R, Mili T, Chowdhury N. Comparison of intravenous carbetocin versus intramuscular oxytocin in management of third stage of labour in vaginal delivery. The New Indian Journal of OBGYN. 2023;10(2):300-304.doi: 10.21276/obgyn.2024.10.2.11