CARBETOCIN VERSUS OXYTOCIN IN THE PREVENTION OF POSTPARTUM HEMORRHAGE FOLLOWING VAGINAL DELIVERY IN HIGH RISK PATIENTS

Abstract

Background: Postpartum hemorrhage is a life threatening situation and one of the important causes of maternal mortality and morbidity, worldwide.Aim of the work: To compare the efficacy of carbetocin and oxytocin in preventing postpartum hemorrhage following vaginal delivery in high risk groups.Patients and methods: 120 women with gestational age between 37-40 weeks at high risk for primary atonic postpartum hemorrhage and delivered vaginally were randomly divided into two groups. First group: included 60 women, they received carbetocin, 100 mcg IM. Second group: included 60 women, they received Oxytocin 5 IU IM. Both groups received their drug after fetal and before placental delivery.Results: There was a statistically significant difference between the two study groups regarding mean blood loss (276.93 ± 120.87 versus 346.42 ± 176.61), occurrence of PPH (3.3% versus 13.3%), hemoglobin and hematocrit difference between before and 24 h after delivery (0.55 ± 0.51 versus 0.998 ± 0.69, p= 0.002) (3.38 ±2.92 versus 4.65±4.18, p= 0.002) respectively and measured hemoglobin and hematocrit 24 h after delivery (being higher in carbetocin group). The effect of carbetocin as regard to estimated blood loss was more obvious in multiparous women. However, there was no significant difference between the two groups regarding need for other uterotonics, the need for blood transfusion and occurrence of nausea, vomiting, abdominal pain, flushing, tachycardia, hypotension, headache, itching and metallic taste.Conclusions: Carbetocin is a better alternative to oxytocin in prevention of PPH after vaginal delivery with similar side effects.