Chowdary Vadlamudi Keerthi, Mudanur Subhashchandra R, Yaliwal Rajasri G, Kori Shreedevi, Chhabra Ekta
Obstetrics and Gynaecology, Shri BM Patil Medical College and Hospital, BLDE (Deemed to be University), Vijaypura, IND.
Obstetrics and Gynaecology, Shri BM Patil Medical College and Hospital, BLDE (Deemed to be University), Vijayapura, IND.
Cureus. 2025 May 19;17(5):e84426. doi: 10.7759/cureus.84426. eCollection 2025 May.
Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality, particularly following cesarean sections. While oxytocin is the standard uterotonic agent, carbetocin, a long-acting synthetic analogue, may offer improved efficacy due to its prolonged uterotonic effect and better stability.
This study aimed to compare the effectiveness of intravenous carbetocin (100 mcg) versus oxytocin (10 IU) in preventing PPH following emergency cesarean sections by evaluating blood loss, the need for additional uterotonics, and maternal hemodynamic stability.
A total of 350 women undergoing emergency cesarean section were randomly assigned to receive either carbetocin (Group A) or oxytocin (Group B). Intraoperative blood loss, uterine tone, and hemodynamic parameters were measured. Statistical analysis was performed using IBM SPSS Statistics software, version 26 (IBM Corp., Armonk, NY).
Carbetocin was associated with significantly lower blood loss ≥1000 ml (13(7.43%) vs. 33(18.86%), p = 0.0015) and a reduced need for additional uterotonics (10(5.71%) vs. 21(12%), p = 0.0385). Uterine tone was superior in the carbetocin group at three and five minutes post-administration (p = 0.023 and p = 0.003, respectively). Both drugs had similar safety profiles, with no significant differences in adverse effects.
Carbetocin demonstrated superior efficacy in preventing PPH compared to oxytocin, with lower blood loss, reduced need for additional interventions, and improved uterine tone. Carbetocin is a viable and safer alternative to oxytocin for PPH prevention, especially in emergency cesarean sections.
产后出血（PPH）是孕产妇发病和死亡的主要原因，尤其是在剖宫产术后。虽然缩宫素是标准的宫缩剂，但卡贝缩宫素作为一种长效合成类似物，因其延长的宫缩作用和更好的稳定性，可能具有更高的疗效。
本研究旨在通过评估失血量、额外宫缩剂的需求以及产妇血流动力学稳定性，比较静脉注射卡贝缩宫素（100微克）与缩宫素（10国际单位）在预防急诊剖宫产术后PPH方面的有效性。
总共350例行急诊剖宫产的妇女被随机分配接受卡贝缩宫素（A组）或缩宫素（B组）。测量术中失血量、子宫张力和血流动力学参数。使用IBM SPSS Statistics软件26版（IBM公司，纽约州阿蒙克）进行统计分析。
卡贝缩宫素组≥1000毫升的失血量显著更低（13例（7.43%）对33例（18.86%），p = 0.0015），且额外宫缩剂的需求减少（10例（5.71%）对21例（12%），p = 0.0385）。给药后3分钟和5分钟时，卡贝缩宫素组的子宫张力更好（分别为p = 0.023和p = 0.003）。两种药物的安全性相似，不良反应无显著差异。
与缩宫素相比，卡贝缩宫素在预防PPH方面显示出更高的疗效，失血量更低，额外干预需求减少，子宫张力改善。卡贝缩宫素是预防PPH的一种可行且更安全的缩宫素替代药物，尤其是在急诊剖宫产术中。
