Carbetocin versus oxytocin in prevention of postpartum hemorrhage in late preterm twin pregnancy following cesarean section: a prospective clinical study

Abstract

ObjectiveThe objective of this study was to compare effectiveness and safety of carbetocin versus oxytocin infusion in prevention of postpartum hemorrhage (PPH) in women with late preterm twin pregnancy undergoing cesarean section.Patients and methodsA prospective clinical study was conducted from June 2014 to August 2015 in Shibin El-Kom and Benha Teaching Hospitals in Egypt that enrolled 175 women with late preterm twin pregnancy undergoing cesarean section. Carbetocin group (n = 90) as a single intravenous bolus was compared with oxytocin (n = 85) 10 IU as six infusions as soon as the second twin was delivered, and the outcomes were compared.ResultsThe mean blood loss during cesarean section was higher in oxytocin group as compared with carbetocin (685 ± 350 vs. 782.8 ± 370 ml, P > 0.05). The incident of primary PPH (>1000 ml) in cesarean delivery was lower in carbetocin group versus oxytocin group (3.33 vs. 11.76%, P < 0.05). The difference between hemoglobin levels 24 h after delivery was not significantly lower in carbetocin group (P > 0.05). The need for another uterotonic agents in carbetocin was lower than in oxytocin (23.33 vs. 35.29%, P < 0.05).ConclusionThis study found that carbetocin was an acceptable option with reduction of PPH compared with oxytocin in late preterm twin pregnancy undergoing cesarean section, and both had similar safety profile with minor hemodynamic effect.