Carbetocin Versus Misoprostol For Prevention Of Atonic Postpartum Haemorrhage In Women Undergoing Elective Caesarean Section: A Randomized Controlled Trial

Abstract

The study included one hundred forty pregnant women undergoing elective lower segment cesarean section at term (completed 37 weeks of gestation or more) under regional anesthesia (although general anesthesia is a risk factor for atonic postpartum hemorrhage, it was excluded for standardization of cases). Patients who had one or more of the following criteria were included in the trial (risk factors for atonic postpartum hemorrhage): Over distended uterus (multiple pregnancy, polyhydramnios, fetal macrosomia or uterine fibroid), use of uterine relaxant drugs during pregnancy, grand multiparity (more than 5 delivaries) and Previous postpartum hemorrhage. Divided into two groups: group one included seventy women received Carbetocin (Ampoule 100 μg/ml) diluted in 10 ml normal saline and administered slowly (over 30– 60 seconds) intravenously just after delivery of the neonate during CS and group two included seventy women received Misoprostol 800mcg (4 tablets) rectal immediately before caesarean section. The current study showed a significant difference between the two study groups as regard the need for additional uterotonics (pvalue0.001), in misoprostol group was 20.0% (14 cases), in carbetocin group was 2.9% (2 cases).