Comparing the Efficacy of Carbetocin during an Elective Cesarean Section in Preventing Postpartum Hemorrhage in Obese versus Non–Obese Women

Abstract

Background: One of the most frequent preventable causes of maternal death is still obstetric hemorrhage. The World Health Organization advises using carbetocin to avoid post-partum hemorrhage in all pregnancies, especially in situations when oxytocin is not available.

Objective:This study aimed to assess how well carbetocin worked in obese full-term pregnant women to improve uterine contraction and reduce blood loss.

Subjects and methods: Between July 2023 and October 2023, 150 pregnant women who were admitted for an elective cesarean section  at term, were included in this prospective randomized controlled clinical study. Two equal groups of pregnant women were formed: 75  women in the study group had a body mass index (BMI) of at least 30 kg/m2 and 75 women in the control group had a BMI of less than  30 kg/m2 . Following cord clamping, each woman received a one-minute intravenous bolus of 100 mcg carbetocin as the research  medication. Estimation of blood loss was done by measuring the volume of blood of intraoperatively utilized blood-soaked towels and  comparing preoperative and 24-hour post-delivery hemoglobin and hematocrit values.

Results:Among the groups being studied, no  statistically significant difference was found with respect to hemoglobin level, hematocrit level, uterine tone, mean weighted blood loss,  or estimated blood loss at birth. Neither the requirement for blood transfusions nor the adverse effects of the medication varied  significantly between the groups under study. No cases indicated that more uterotonic medications were required.

Conclusion: Obesity  does not appear to have an impact on carbetocin's ability to prevent PPH.