Comparative study between effect of carbetocin and oxytocin on isoflurane-induced uterine hypotonia in twin pregnancy patients undergoing cesarean section

Abstract

Background: Carbetocin is a long acting structural analog of human oxytocin and is given as single IV bolus following the delivery; it is effective as an oxytocin infusion for several hours because the latter has a very short duration of action which requires a continuous infusion to achieve sustained uterotonic activity. Multiple pregnancy is one of the most common causes of postpartum hemorrhage. This study was done to compare the effect of carbetocin and oxytocin on uterine contraction and though the use of other uterotonic drugs postoperative in multiple pregnancy patients undergoing elective C.S. Patients and methods: Sixty patients were enrolled in this study, and they were classified randomly into two groups: group C = received 100 μg carbetocin, group O = received 20 IU oxytocin. We compared between the two groups as regard hemodynamic parameters (heart rate and mean arterial blood pressure), uterine contraction, amount of blood loss and number of patients who needed to reduce isoflurane concentration. Results: As regards uterine contraction group O needed methylergometrine postoperative significantly more than group C and as regards blood loss; it was significantly decreased more in group C and though less reduction in blood pressure and less effect on heart rate than group O. Conclusion: Single dose of carbetocin appears to be more effective than oxytocin for several hours on uterine contraction and though preventing postpartum hemorrhage in multiple pregnancy patients undergoing elective caesarian section.

Keywords

• Twin pregnancy
• Caesarian section
• Postpartum hemorrhage
• Carbetocin
• Oxytocin