Postpartum hemorrhage is a preventable event in abdominal and vaginal seliviries. Conventional incremental dosing or continous infusion of oxytocin has been employed for these. Carbetocin, as an anlogue is associated with longer half-life and has clinical benefits.

OBJECTIVE: The objective was to compare the effectiveness of carbetocin and oxytocin when administered after elective uncomplicated cesarean section (CS) for the prevention of postpartum hemorrhage.

DESIGN: Randomized single blind controlled trial of patients admitted at Rizal Medical Center from June to October 2012.

PARTICIPANTS AND METHODS: A total of 70 patients were randomized to carbetocin (n=35) and oxytocin (n=35) for the prevention of postpartum hemorrhage and analyzed by intention-to treat. Baseline demographic and obstetric profile, indications for CS, estimated blood loss, hematocrit, hemoglobin, need for uterine massage, additional uterotonics, uterine tone and involution were compared immediate post-operative and 24 hours after.

RESULTS: Baseline profiles were similar between the two groups. Post-operatively, hemoglobin and hematocrit levels in the carbetocin in group were statistically significant and were associated with lesser need for additional uterotonic agents, uterine massage and a well contracted uterus immediate post-operative and 24 hours thereafter. The estimated blood loss was significantly lower in the carbetocin group however , the two groups did not significantly differ in terms of blood transfusion requirements and post-op blood pressure.

CONCLUSION: Carbetocin as a uterotonic agent is an acceptable alternative for the prevention of postpartum bleeding in elective cesarean section. A cost-benefit analysis is mandated.