Evidence for carbetocin in obstetric hemorrhage

Abstract

Introduction: a common procedure is to administer uterotonic agents regularly for the prophylaxis of postpartum and post-cesarean hemorrhage. The typical uterotonic drug recommended for this use is oxytocin, however, literature indicates better beneficial effects with carbetocin due to its sustained and prolonged uterotonic activity, as well as its safety and good tolerability. Objective: to outline the data on carbetocin that has been found so far in relation to obstetric hemorrhage. Methods: For this literature review, keywords related to carbetocin and obstetric hemorrhage were located using health sciences descriptors, and then searched in databases and search engines such as Google Scholar, PubMed, Lilacs, SciELO, Cochrane, and PubMed. Out of a total of 100 bibliographies, 32 articles were considered. Results: Carbetocin is a thermally stable drug with a half-life approximately 4-10 times longer than oxytocin, with sustained uterotonic activity with the administration of a single dose (100 μg) intravenously or intramuscularly. Conclusions: Carbetocin is a safe drug for prescription in patients with specific pathologies, as it maintains prolonged uterotonic effect, useful in post-cesarean hemorrhages. Its use is not yet fully promoted due to the high cost it represents at present.