Trivedi Kiran, Sinha Tulika, Boipai Payal, Kumari Pooja, Sharma Apoorwa, Singh Achala, Kumari Shiwani
Department of Obstetrics and Gynecology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Department of Obstetrics and Gynecology, BVMC, Pune, Maharashtra, India.
Ann Afr Med. 2025 Apr 1;24(2):378-383. doi: 10.4103/aam.aam_218_24. Epub 2025 Mar 11.
Preventing postpartum haemorrhage (PPH) is a significant concern because of its effect on maternal morbidity and mortality. PPH is leading cause of maternal death in developing countries and also globally.
Evaluation of safety and efficacy of carbetocin versus oxytocin for PPH prevention in caesarean deliveries.
Double blind randomised controlled trial carried for one year. 42 pregnant patients included in study, who underwent caesarean section and fulfilled inclusion criteria. Patients divided into two groups A and B with 21 in each group, with the help of computer generated random number, group A recieved 100 microgram of carbetocin through intravenous route and 1 ml of normal saline given intramuscularly as placebo, group B received 10 IU oxytocin through intramuscular route and 1 ml of normal saline is given intravascular.
Mean age was 25.19 years±3.86 years and 24.76 years±3.93 in group A and group B respectively. Mean blood loss significantly reduced in carbetocin compared to oxytocin with significant p value 0.006, haemoglobin deficit was less in group A as we compare with group B having p value 0.052 whereas incidence of PPH in group A was 4.76 % and group B was 19.05% and had p value of 0.343, not significant. Effect of both medication on blood loss varies significantly across different BMI categories.
Observation shows equal efficacy and safety of both carbetocin and oxytocin in prevention of postpartum haemorrhage in caesarean section but carbetocin is considered as uterotonics of crucial importance due to heat stability in poor resource settings, therefore use of carbetocin could be better in comparison to oxytocin in PPH prevention.
产后出血（PPH）因其对孕产妇发病率和死亡率的影响而备受关注。PPH是发展中国家以及全球孕产妇死亡的主要原因。
评估卡贝缩宫素与缩宫素预防剖宫产产后出血的安全性和有效性。
进行了为期一年的双盲随机对照试验。42名纳入研究的孕妇接受了剖宫产并符合纳入标准。患者被分为A组和B组，每组21人，借助计算机生成随机数，A组通过静脉途径接受100微克卡贝缩宫素，并肌肉注射1毫升生理盐水作为安慰剂，B组通过肌肉途径接受10国际单位缩宫素，并血管内给予1毫升生理盐水。
A组和B组的平均年龄分别为25.19岁±3.86岁和24.76岁±3.93岁。与缩宫素相比，卡贝缩宫素组的平均失血量显著减少，p值为0.006，与B组相比，A组的血红蛋白缺乏较少，p值为0.052，而A组的产后出血发生率为4.76%，B组为19.05%，p值为0.343，无统计学意义。两种药物对失血量的影响在不同BMI类别中差异显著。
观察表明，卡贝缩宫素和缩宫素在预防剖宫产产后出血方面具有相同的疗效和安全性，但由于在资源匮乏地区的热稳定性，卡贝缩宫素被认为是至关重要的宫缩剂，因此在预防产后出血方面，与缩宫素相比，使用卡贝缩宫素可能更好。
