Comparative Clinical Study for Uterotonic Drugs Used in Reducing Postpartum Haemorrhage for Risky Patients in Caesarean Section

Abstract

Background: Obstetric hemorrhage is the most prevalent cause of maternal death. Uterine atony accounts for around 80% of  postpartum hemorrhage (PPH) cases.

Objectives: This study aimed to compare between oxytocin and carbetocin in the prevention of PPH in Caesarean section (CS).

Methods: This prospective observational study was carried out on 100 female participants with risk factors of PPH delivered by CS at the  Obstetrics and Gynecology Department, Menoufia University Hospitals. They were divided into 2 groups: Group 1 that included 50  pregnant women who received 100 mcg/ml of carbetocin and group 2 that included 50 pregnant women who received 10 IU of oxytocin  infusion (8ml/m over one hour). All participants were subjected to full medical history and full clinical examination. Vital signs,  intraoperative blood loss estimation, routine investigations (CBC, ABO, Rh, RBS, Coagulation profile, S. creatinine & urinalysis and LFT),  and obstetric US were done for all females.

Results: Overall 100 participants that were recruited, there was no significant difference  regarding demographic data. Group 2 (oxytocin) had significantly lower hemoglobin levels and hematocrit l2 hours & 24 hours  postoperatively. Group 1 had better uterine contractions than group 2. There were 17 cases in group 2 that needed additional uterotonic drugs with a p-value <0.001. There were 6 cases in group 2 that developed PPH and 4 of them needed blood transfusion.

Conclusion: A  single intravenous injection of carbetocin (100 mcg) was more effective than a continuous intravenous infusion of oxytocin (10 IU) for  maintaining uterine tone and prevention of PPH.