CARBETOCIN VERSUS OXYTOCIN IN PREVENTION OF POSTPARTUM HAEMORRHAGE IN PATIENTS UNDERGOING CAESAREAN SECTION

Abstract

BACKGROUND: In Indian medical practice, direct comparisons between different medical treatments, such as the safety & efficacy of carbetocin versus oxytocin for preventing postpartum haemorrhage. Addressing this deficiency by conducting localized studies could greatly enhance clinical outcomes by tailoring interventions to meet the specific needs and circumstances of the Indian population. AIM: To assess the efficacy of carbetocin and oxytocin in terms of intraoperative blood loss and the need of additional uterotonic in caesarean sections for management of postpartum haemorrhage. The study also examined the hemodynamic effects of oxytocin and carbetocin. STUDY DESIGN & METHODS: A prospective comparative study was conducted between September 2022 and December 2023 in the Department of Obstetrics & Gynaecology at R L JALAPPA HOSPITAL AND RESEARCH CENTRE in kolar, Karnataka. RESULTS: We recruited a total of 82 participants in the study, 41 (50%) each in both the groups. Majority of participants (n=34, 41.5%) belonged to 21 to 25 years category. The median GA was 38 weeks (IQR: 38 to 39 weeks). The distribution of GA was same in both the groups (p=0.97). Participants in the carbetocin group had significantly lower suction volumes (p<0.001), and mop counts (p=0.02). Additionally, fewer participants in the carbetocin group required blood transfusions (0% vs. 7.3%) (p=0.07). Carbetocin group was superior in terms of additional uterotonic requirement (4.9% vs. 29.3%, p=0.003) and additional procedures requirement (0% vs14.6% within the group receiving oxytocin, p=0.01). Metallic taste found to be an important side effect for the carbetocin group (11.9%). xxi CONCLUSION: Carbetocin more effective than oxytocin in reducing intraoperative blood loss and preventing postpartum haemorrhage (PPH) during caesarean sections, with significantly lower suction volumes, mop counts, and need for additional uterotonics. Despite minor side effects for both drugs, carbetocin shows a more favorable safety and efficacy profile, though it uniquely causes a metallic taste.