Intravenous Carbetocin versus Oxytocin in Management of Placental Delivery in Second Trimester Interruption A Randomized Clinical Trial

Abstract

This randomized controlled study was conducted at Ain Shams University Maternity Hospital, the study included 132 women at reproductive age who were admitted for pregnancy interruption for severe fetal anomaly or IUFD at gestational age between 14-24 weeks. The aim of this study was to assess the efficacy of carbetocin in preventing placental retention and decreasing blood loss after 2nd trimesteric abortion. The patients were randomly divided into 2 groups; Group I: it included 66 patients who received intravenous 100 μg Carbetocine after delivery of the fetus.Group II: it included 66 patients who received intravenous infusion 20 IU Oxytocin after delivery of the fetus. The present study showed that the mean duration of 3rd stage was 33.410 minutes with a standard deviation of ±20.440 in the oxytocin group while in the carbetocin group it was 23.081minutes with a standard deviation of ±16.806 and this difference was statistically significant (p= 0.002). In this study 8 patients (12.12%) of the oxytocin group had placental retention while in the carbetocin group it was 2 patients (3.03%) and this difference was statistically significant. Apart from these patients who had retention of the placenta (10 

patients), all patients had undergone an ultrasound scan to assess the presence of reminants which showed that 8 patients (13.79%) of the oxytocin group had reminants versus 4 patients (6.25%) in the carbetocin group, and this difference was statistically significant.