Comparative study between the effect of carbetocin versus oxytocin plus sublingual misoprostol and oxytocin in the management of postpartum blood loss > 500 ml after vaginal delivery: a randomized controlled trial


Objective. In comparison to oxytocin alone, researchers wanted to examine how carbetocin and oxytocin plus sublingual misoprostol influenced the estimated and measured amount of blood loss following vaginal birth in women who had blood loss > 500 ml.
Patients and Methods. 135 women with blood loss greater than 500 ml after vaginal delivery were recruited in the current randomized open-label clinical trial at a tertiary university hospital between April 2019 and December 2022 (NCT03870503), after receiving standard treatments for managing the third stage of labour and signing an informant consent. They were separated into three groups: group 1 received 100 μg of carbetocin (Pabal Ferring, UK), group 2 received 400 μg of sublingual misoprostol with 20 IU of oxytocin (Syntocinon, Novartis, Switzerland), and group 3 received just 20 IU of oxytocin. Blood loss of 500 millilitres or less following postpartum haemorrhage therapy was the main goal.
Results. When compared to the carbetocin and oxytocin plus misoprostol groups, the oxytocin group had a substantial drop in haemoglobin concentration and a significant increase in estimated blood loss (p = 0.0001; 0.0001, respectively). The estimated blood loss in the oxytocin plus misoprostol group was significantly lower than in the carbetocin group (p = 0.004). When comparing the carbetocin (13.3%) to the oxytocin plus misoprostol group (11.1%) and the oxytocin (24.4%), the incidence of postpartum blood loss > 1,000 ml was higher in the oxytocin group (p = 0.0001).
Conclusions. Oxytocin plus misoprostol is more effective than oxytocin and carbetocin in the management of post-partum blood loss > 500 ml after vaginal delivery.

Table of Content: Vol. 36 (No. 2) 2024 June

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