To study the efficacy of a single bolus dose of carbetocin for prevention of postpartum haemorrhage in elective caesarean section under spinal anaesthesia: a randomized clinical trial

Abstract

Background: Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, with an estimated mortality of 140 000 per year. The majority of them can be prevented by using "active management of the third stage of labour". Carbetocin is a long-acting synthetic oxytocin analogue, first described in 1987. Objectives: The current study aimed to evaluate the efficacy of carbetocin in preventing intraoperative blood loss and to observe its haemodynamic effects. Methods: 120 patients with a gestation of 37 weeks or more, who had an elective caesarean delivery under spinal anaesthesia, were included in this study. Patients were divided into two groups (Group CT and Group C). Women in the carbetocin group (group CT) received a bolus of 100 IU of carbetocin IV and group C received oxytocin infusion after delivery of the anterior shoulder. Mean effective blood loss, HR and MAP, complications like nausea and vomiting, palpitation, and headache were the parameters used in the study. Results: There was no incidence of PPH in both groups. Mean effective blood loss in group CT was 423. 0 ± 150.1ml and 635.3 ± 245.4 ml in group C respectively. 6 no of the patients needed rescue oxytocin in Group C. There was a statistically decrease in the mean total dose of mephentermine in group CT (23. 8 ± 12. 0) than group (56. 8 ± 8.6). Conclusion: A single bolus dose of carbetocin is more effective and haemodynamically stable in preventing PPH in caesarean section than the standard oxytocin regime.

Keywords

• carbetocin
• caesarean section
• pph
• spinal anaesthesia