Carbetocin versus oxytocin for management of third stage of labour in women at high risk of postpartum haemorrhage in a low resource setting: a randomized controlled trial

Aim: To compare the efficacy of carbetocin with oxytocin for prevention of postpartum haemorrhage. Materials and Methods: This was a double-blind randomized controlled trial conducted at the Alex Ekwueme Federal University Teaching Hospital Abakaliki, Southeast, Nigeria between 3rd January 2018 to 31st December 2018. One hundred parturients at high risk of postpartum haemorrhage following vaginal delivery were randomly assigned to receive either intramuscular carbetocin 100µg or oxytocin 10IU within one minute after delivery of the baby. The data analysis was performed using SPSS version 22. Results: The need for additional uterotonics was significantly lower in carbetocin group when compared with oxytocin group (18% versus 44%, RR = 0.4, 95%CI = 0.21-0.79, P-value = 0.008). The estimated blood loss > 500 ml was significantly higher among study participants that received oxytocin (18% versus 40%, RR = 0.4, 95%CI = 0.20-0.80, P-value = 0.009). Even though that the blood loss > 1000 ml was lower in the carbetocin arm of the study, this difference did not reach statistical significance (8% versus 18%, RR = 0.4, 95%CI = 0.15-1.35, P-value = 0.15). Conclusion: Carbetocin reduces the use of additional uterotonics following vaginal delivery in women at high risk of PPH when compared to standard dose of oxytocin. It also reduced the incidence of PPH in these women.