The New Indian Journal of OBGYN. 10(2):300-304

Comparison of intravenous carbetocin versus intramuscular oxytocin in management of third stage of labour in vaginal delivery

Kanupriam Tai, Karabi Barman, Rajesh Das, Trinayan Mili, Nilanjan Chowdhury

ABSTRACT

Background: Post-partum hemorrhage (PPH) and its prevention is a major issue globally due to its impact on maternal morbidity and mortality. Active management of the third stage of labour (AMTSL) should be routinely practiced to prevent the risk of PPH. Objectives: Aim of the study was to compare efficacy of intravenous carbetocin and intramuscular oxytocin in management of third stage of labour during vaginal delivery. Methodology: A prospective randomized case-control study was conducted in the Department of Obstetrics and Gynaecology, Fakhruddin Ali Ahmed Medical College and Hospital, over a period of 1 year from September 2021 to August 2022. The 200 parturients undergoing vaginal delivery were divided equally into two groups; Group A - women received carbetocin as a bolus of 100 microgram intravenously and group B - women received oxytocin 10 international units (IU) intramuscularly. Outcome measures such as primary PPH, amount of blood loss, need for additional uterotonic drugs, additional blood transfusion and adverse effects were compared postpartum. Results: Although, the mean blood loss was lesser in the carbetocin group than that of the oxytocin group with no statistical difference (p value = 0.464), there was a significant statistical difference in incidence of PPH (11% vs 23%; p = 0.037), additional uterotonics requirement (21% vs 35%; p= 0.04) and mean fall in hemoglobin level (p value = 0.0002) between carbetocin and oxytocin groups respectively. Adverse effects of drugs were almost similar in both the groups. Conclusion: Carbetocin was found to be an effective new drug over oxytocin for prevention of PPH in vaginal delivery.