Carbetosine, a Long-acting Oxytocin Agonist, as a Uterotonic in the Prevention of the Occurrence of Postpartum Bleeding

Abstract

Objective: To evaluate the comparative effect of carbetocin versus other uterotonic agents (misoprostol and oxytocin) in preventing postpartum bleeding. Methods: Medical search engines such as Pubmed, Google Scholar, and Cochrane were used for literature searches. The literature covered the period from 2013 to 2023. Keywords used were “Carbetocin” or “long-acting oxytocin” and “uterotonic”, “post-partum hemorrhage” or “post-partum bleeding.” Data analysis was conducted using the RevMan 5.4 application. Results: This study involved 12 clinical trials involving a total sample of 32,312 people. Based on forest plot analysis, it was found that patients receiving carbetocin therapy had a 0.42 times lower risk of developing postpartum compared to those receiving other uterotonic agents (misoprostol and oxytocin) (OR: 0.42; 95% CI: 0.26-0.68; p<0.0004; with heterogeneity p<0.00001, I2 85%) Conclusion: Carbetocin, with its effectiveness and efficacy, can be considered as one modality for preventing postpartum hemorrhage in comparison to other uterotonic agents, such as misoprostol and oxytocin. In addition to that, it can benefit women at risk of having a major obstetric hemorrhage.