ROLE OF OXYTOCIN VERSUS CARBETOCIN IN ACTIVE MANAGEMENT OF THIRD STAGE OF LABOR

Background and aims: Post partum haemmohrage is the most common cause of direct maternal death globally. Most of these deaths can be prevented by Active Management of Third Stage of Labour (AMTSL). This prophylactic use of uterotonic agents in the AMTSL aids in preventing life threatening haemorrhage. This study compares Oxytocin and its newer analogue Carbetocin in AMTSL in terms of blood loss, haemodynamic changes, side effects and need for use of additional uterotonics.

Methodology: A prospective observational study was conducted in the Department of Obstetrics and Gynecology, Shri Ram Murti Smarak Institue of Medical Sciences over a period of from 1st September ,2022 to 28th February 2024. Hundred patients undergoing vaginal delivery at term were randomized into two groups receiving either 10IU oxytocin or 100 µg carbetocin. Outcomes were measured such as haemoglobin, amount of blood loss, change in general condition and need for additional uterotonic agents/ any other measure to control PPH.

Results: In this study, massive blood loss did not occur in either groups. The incidence of atonic post-partum haemorrhage was 10% in oxytocin group while in the Carbetocin group, none had atonic PPH. Moreover, none of the women in carbetocin group had blood loss exceeding 500ml. Haemoglobin drop at 24 hours post delivery was observed more in oxytocin group. There was no difference in neonatal outcome in terms of NICU admission in both the groups.  

Conclusion: Carbetocin is an effective and heat stable analogue that has potential to be used as first line drug in AMTSL.