Photo Credit: Aziz Karimov
The following is a summary of “A systematic review and meta-analysis of randomized trials comparing carbetocin to oxytocin in prevention of postpartum hemorrhage after cesarean delivery in low-risk women,” published in the December 2024 issue of Obstetrics and Gynecology by Maged et al.
Postpartum hemorrhage (PPH) is a major complication after cesarean delivery (CD), leading to maternal morbidity. Carbetocin, a synthetic oxytocin analog, is thought to have a more sustained uterotonic effect than oxytocin.
Researchers conducted a retrospective study to evaluate the efficacy and safety of carbetocin compared to oxytocin for preventing PPH in low-risk women undergoing CD.
They screened Medline, Web of Science, Scopus, and Google Scholar (January 2024) for RCTs comparing carbetocin and oxytocin in preventing PPH in low-risk women undergoing CD; 17 RCTs involving 3667 participants were included. Outcomes included the need for additional uterotonic agents, blood transfusions, hemoglobin levels, PPH incidence, and AEs.
The results showed that the need for additional uterotonic agents was lower with carbetocin (OR 0.53, 95% CI 0.39–0.72, P<0.001, I2 41%). The incidence of PPH was similar between both groups (OR 1.08, 95% CI 0.81–1.44, P=0.61, I2 0%). Hemoglobin drop was significantly lower with carbetocin (mean difference [MD] −0.08, 95% CI −0.10 to −0.06, P<0.001, I2 0%). The need for blood transfusion was also lower with carbetocin (OR 0.57, 95% CI 0.34–0.97, P=0.04, I2 0%).
The study concluded that carbetocin administration during CD in women at low risk for PPH reduces the need for additional uterotonics, blood transfusions, and hemoglobin drop without increasing adverse effects, compared to oxytocin.
Source: obgyn.onlinelibrary.wiley.com/doi/10.1111/jog.16194
