Oxytocin Vs Carbetocin in Managgement of 3rd Stage at Risk of PPH

Abstract

Background: Postpartum haemorrhage occurs in approximately 4% of vaginal deliveries and estimates that it causes significant morbidity and 25% of all maternal childbirth related deaths. Objectives: The aim of the study was to compare between oxytocin and carbrtocin in the active mangment of the 3rd stage of labour after elective cesarean section. Subjects and methods: The study was performed in Obstetrics and Gynecology department of enoufia University hospital, Menoufia governate, Egypt. A total of 88 women eligible in the study were randomly divided into two equal groups, women who received oxytocin (group 1) and women who received carbetocin (PABAL®FERRING Pharmaceuticals LTD) (group 2). Intra-Operative uterine bleeding is calculated by adding number and weight difference of cloths used during delivery (where 100g increase in the weight of the cloths use is considered equivalent to 100ml of blood lost). Post-operative bleeding in the first 6 hours, calculated by number and weight difference of pads used. The monitoring and anesthetic techniques were identical for all women. Results: The results showed highly significant difference between oxytocin group and carbetocin group as regarding haemoglobin delta change (mean of oxytocin group = -0.0489 Vs. mean of carbetocin group = -0.1148, p = 0), that carbetocin is more potent and demonstrated in their study an increased use of additional oxytocics in the oxytocin arm. According to blood loss of the women involved in this study in oxytocin group range between 250 and 950 ml, with the mean of 434.706 ml and SD is 191.799, in carbetocin group range between 250 and 750 ml, with the mean of 366.477 ml and SD is 165.001 the results showed significant difference between oxytocin group and carbetocin group as regarding blood loss (p = 0.013). Conclusion: According to the results of this study it is found that there is a good overall agreement that Carbetocin might be effective in controlling the amount of blood loss during cesarean section and giving a better chance in prevention of atonic postpartum Hemorrhage.