Evaluating the efficacy of carbetocin versus oxytocin for preventing intraoperative blood loss, early postpartum hemorrhage, and maintaining a favorable hemodynamic profile in lower segment cesarean section: A prospective observational study
Background: Postpartum hemorrhage (PPH) remains a significant concern in obstetric practice, contributing substantially to maternal morbidity and mortality worldwide. Uterine atony, characterized by inadequate uterine muscle tone, constitutes approximately 70% of PPH cases. The initial step in medic...
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Manipal College of Medical Sciences, Pokhara
2025-02-01
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| Series: | Asian Journal of Medical Sciences |
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| Online Access: | https://ajmsjournal.info/index.php/AJMS/article/view/4365 |
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| author | Bisma Fayaz Raja Suhail Shounthoo Ajaiz Rasool Saima Wani Showkat Ahmad Gurcoo |
| author_facet | Bisma Fayaz Raja Suhail Shounthoo Ajaiz Rasool Saima Wani Showkat Ahmad Gurcoo |
| author_sort | Bisma Fayaz |
| collection | DOAJ |
| description | Background: Postpartum hemorrhage (PPH) remains a significant concern in obstetric practice, contributing substantially to maternal morbidity and mortality worldwide. Uterine atony, characterized by inadequate uterine muscle tone, constitutes approximately 70% of PPH cases. The initial step in medical management involves the use of uterotonic agents such as oxytocin, ergot alkaloids, and prostaglandins. However, their use is compounded by the accompanying side effects, hence the need for uterotonic agents with relatively better pharmacokinetic and pharmacodynamic profile continues. Carbetocin may require less additional uterotonic administration to manage blood loss compared to oxytocin alone. Carbetocin has a significantly longer half-life than oxytocin, potentially leading to more sustained uterine contractions and reduced blood loss.
Aims and Objectives: The aim of this study was to compare the efficacy of carbetocin versus oxytocin in preventing intraoperative blood loss and their individual impact on hemodynamics.
Materials and Methods: A total of 360 patients were enrolled for the study, sample size was calculated using Cochran’s formula considering 95% confidence level, and 0.5 variability of proportions and a precision of 5%, with 180 patients in each group, using simple randomization technique, the patients in either group received their assigned drugs during lower segment cesarean section (LSCS). Both the groups were assessed in terms of hemodynamic profile, intraoperative blood loss, need for additional uterotonic agents, and blood transfusion.
Results: On comparing the data between carbetocin group and oxytocin group, the carbetocin group had less incidence of hypotension and tachycardia (P<0.001), less intraoperative blood loss (Group C: Group O, mean±SD mL; 328.7±72.59:435.9±99.08 [P<0.001]), and minimal use of additional uterotonic agents (P<0.001); however, the requirement of blood transfusion was comparable between the two groups (P=0.157).
Conclusions: Carbetocin is an effective alternative to conventionally used oxytocin in LSCS. |
| format | Article |
| id | doaj-art-b6841a5c504b476c8046d87c415604ba |
| institution | Kabale University |
| issn | 2467-9100 2091-0576 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Manipal College of Medical Sciences, Pokhara |
| record_format | Article |
| series | Asian Journal of Medical Sciences |
| spelling | doaj-art-b6841a5c504b476c8046d87c415604ba2025-02-01T12:13:14ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762025-02-011627480https://doi.org/10.71152/ajms.v16i2.4365Evaluating the efficacy of carbetocin versus oxytocin for preventing intraoperative blood loss, early postpartum hemorrhage, and maintaining a favorable hemodynamic profile in lower segment cesarean section: A prospective observational studyBisma Fayaz 0https://orcid.org/0009-0003-3309-0831Raja Suhail Shounthoo 1https://orcid.org/0009-0008-3833-4053Ajaiz Rasool 2https://orcid.org/0009-0001-7259-4755Saima Wani 3https://orcid.org/0009-0008-5595-5433Showkat Ahmad Gurcoo 4https://orcid.org/0000-0001-7873-3552Postgraduate Resident, Department of Anaesthesiology, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India Assistant Professor, Department of Anaesthesiology, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India Assistant Professor, Department of Anaesthesiology, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India Associate Professor, Department of Obstetrics and Gynaecology, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India Professor and Head, Department of Anaesthesiology, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India Background: Postpartum hemorrhage (PPH) remains a significant concern in obstetric practice, contributing substantially to maternal morbidity and mortality worldwide. Uterine atony, characterized by inadequate uterine muscle tone, constitutes approximately 70% of PPH cases. The initial step in medical management involves the use of uterotonic agents such as oxytocin, ergot alkaloids, and prostaglandins. However, their use is compounded by the accompanying side effects, hence the need for uterotonic agents with relatively better pharmacokinetic and pharmacodynamic profile continues. Carbetocin may require less additional uterotonic administration to manage blood loss compared to oxytocin alone. Carbetocin has a significantly longer half-life than oxytocin, potentially leading to more sustained uterine contractions and reduced blood loss. Aims and Objectives: The aim of this study was to compare the efficacy of carbetocin versus oxytocin in preventing intraoperative blood loss and their individual impact on hemodynamics. Materials and Methods: A total of 360 patients were enrolled for the study, sample size was calculated using Cochran’s formula considering 95% confidence level, and 0.5 variability of proportions and a precision of 5%, with 180 patients in each group, using simple randomization technique, the patients in either group received their assigned drugs during lower segment cesarean section (LSCS). Both the groups were assessed in terms of hemodynamic profile, intraoperative blood loss, need for additional uterotonic agents, and blood transfusion. Results: On comparing the data between carbetocin group and oxytocin group, the carbetocin group had less incidence of hypotension and tachycardia (P<0.001), less intraoperative blood loss (Group C: Group O, mean±SD mL; 328.7±72.59:435.9±99.08 [P<0.001]), and minimal use of additional uterotonic agents (P<0.001); however, the requirement of blood transfusion was comparable between the two groups (P=0.157). Conclusions: Carbetocin is an effective alternative to conventionally used oxytocin in LSCS.https://ajmsjournal.info/index.php/AJMS/article/view/4365lower-segment caesarean section; oxytocin; carbetocin; postpartum hemorrhage; obstetric hemorrhage |
| spellingShingle | Bisma Fayaz Raja Suhail Shounthoo Ajaiz Rasool Saima Wani Showkat Ahmad Gurcoo Evaluating the efficacy of carbetocin versus oxytocin for preventing intraoperative blood loss, early postpartum hemorrhage, and maintaining a favorable hemodynamic profile in lower segment cesarean section: A prospective observational study Asian Journal of Medical Sciences lower-segment caesarean section; oxytocin; carbetocin; postpartum hemorrhage; obstetric hemorrhage |
| title | Evaluating the efficacy of carbetocin versus oxytocin for preventing intraoperative blood loss, early postpartum hemorrhage, and maintaining a favorable hemodynamic profile in lower segment cesarean section: A prospective observational study |
| title_full | Evaluating the efficacy of carbetocin versus oxytocin for preventing intraoperative blood loss, early postpartum hemorrhage, and maintaining a favorable hemodynamic profile in lower segment cesarean section: A prospective observational study |
| title_fullStr | Evaluating the efficacy of carbetocin versus oxytocin for preventing intraoperative blood loss, early postpartum hemorrhage, and maintaining a favorable hemodynamic profile in lower segment cesarean section: A prospective observational study |
| title_full_unstemmed | Evaluating the efficacy of carbetocin versus oxytocin for preventing intraoperative blood loss, early postpartum hemorrhage, and maintaining a favorable hemodynamic profile in lower segment cesarean section: A prospective observational study |
| title_short | Evaluating the efficacy of carbetocin versus oxytocin for preventing intraoperative blood loss, early postpartum hemorrhage, and maintaining a favorable hemodynamic profile in lower segment cesarean section: A prospective observational study |
| title_sort | evaluating the efficacy of carbetocin versus oxytocin for preventing intraoperative blood loss early postpartum hemorrhage and maintaining a favorable hemodynamic profile in lower segment cesarean section a prospective observational study |
| topic | lower-segment caesarean section; oxytocin; carbetocin; postpartum hemorrhage; obstetric hemorrhage |
| url | https://ajmsjournal.info/index.php/AJMS/article/view/4365 |
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