Carbetocin Versus Oxytocin And Ergometrine for Prevention of Postpartum Hemorrhage in Women With Twin Pregnancy Undergoing Elective Cesarean Delivery: A Randomized Controlled Trial

Document Type : Original Article


1 obstetric and gynecology, aswan faculty of medicine

2 Aswan university , Aswan ,Egypt


Objective: To evaluate the effectiveness and safety of carbetocin compared with an intravenous infusion of oxytocin 10 IU plus an intramuscular injection of ergometrine 0.2 mg in decreasing blood loss during and after cesarean delivery for twin pregnancies.
Materials and Methods: This was a single-blind, randomized controlled study (NCT03578263). We randomly assigned 170 women who had twin pregnancies and were scheduled for elective or emergency cesarean birth under spinal anesthesia to receive a combination of a continuous intravenous infusion of 10 IU oxytocin in 500 mL 0.9 percent NaCl solution (125 mL/h) for 24 hours and I.M. Ergometrine 0.2mg, or an intravenous infusion of 100 mics gm carbetocin. The Blood loss at and 6 hours after cesarean birth was the primary outcome. We also shared if any more oxytocic medications were required, as well as any drug-related adverse effects.
Results: The total mean blood loss in the carbetocin group was not substantially different from the oxytocin plus ergometrine group (667.65 119.987 vs. 674.16 130.240 mL; p = 0.741). After using carbetocin and oxytocin with ergometrine, 8.2 percent and 10.6 percent of patients required further oxytocic treatment, respectively (p = 0.599). Side symptoms such as headache, nausea, and vomiting were substantially more common in the oxytocin plus ergometrine group than in the carbetocin group (p = 0.004, 0.007, 0.009).
Conclusion: Carbatocin is as effective as oxytocin with ergometrine in decreasing total blood loss during and after cesarean birth in women pregnant with twins, but it has fewer adverse effects.


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