Background: Postpartum haemorrhage (PPH) remains a leading cause of maternal morbidity and mortality worldwide. Effective prophylactic uterotonic agents are essential for preventing primary PPH after childbirth. The study aims to compare the effectiveness and safety of oxytocin versus Carbetocin in preventing primary PPH following both vaginal and caesarean deliveries in a tertiary care setting in Eastern India. Methodology: This prospective, open-label, randomized controlled superiority trial was conducted over 18 months (October 2022–March 2024) at B.R. Singh Hospital, Kolkata. One hundred and twenty pregnant women aged 18–35 years with singleton pregnancies ≥37 weeks undergoing normal vaginal delivery or caesarean section were randomized into two groups. The Oxytocin group (n=60) received 10 IU intravenously with a maintenance dose, while the Carbetocin group (n=60) received 100μg intravenously without a maintenance dose. Primary outcomes included total blood loss and incidence of PPH. Secondary outcomes included uterine atony and additional uterotonic requirements, hemodynamic changes, change in hemoglobin levels, and maternal side effects. Results: Carbetocin significantly reduced total blood loss in both delivery modes (p<0.001). PPH incidence was lower with Carbetocin (17.9% vs 29.6% in caesarean delivery; 9.4% vs 27.3% in vaginal delivery). Post-delivery haemoglobin levels were significantly higher, and haemoglobin drop was significantly lower in the Carbetocin group. Uterine atony occurred less frequently with Carbetocin (23.3% vs 43.3%, p<0.05). Carbetocin caused minimal hemodynamic changes compared to the significant hypotensive effects of oxytocin. Conclusion: Carbetocin is superior to oxytocin in preventing primary PPH, offering better efficacy and safety profile through reduced complications.
Dasghosh et al. (Mon,) studied this question.