A comparative study on the efficacy of intravenous oxytocin and carbetocin in the prevention and management of postpartum hemorrhage in tertiary care hospital in Uttar Pradesh, India

Background: Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality. Oxytocin is widely used as the first-line uterotonic agent; however, carbetocin, a long-acting oxytocin analogue, has shown promise in reducing the need for additional interventions. Aims and Objectives: The aims and objectives of the study are to compare the effectiveness and safety of intravenous oxytocin and intravenous carbetocin in the prevention and management of PPH among pregnant women undergoing lower-segment cesarean section and vaginal delivery. Materials and Methods: This prospective, randomized, comparative study was conducted on 100 women (50 in each group) receiving either intravenous oxytocin or carbetocin immediately after delivery. Baseline maternal characteristics, incidence of PPH, need for additional interventions, and side effects were recorded. The data were entered in MS Excel. Analysis was carried out using Jamovi v2.3.26.0, and P<0.05 was considered statistically significant. Results: Baseline characteristics such as age, body mass index, gravida status, and gestational age were comparable between the two groups (P>0.05). The overall incidence of PPH was 24%, with slightly higher rates in the oxytocin group (54.2%) compared to the carbetocin group (45.8%). The need for additional uterotonics, uterine massage, and blood transfusion was more frequent in the oxytocin group. Surgical interventions, including B-Lynch sutures and hysterectomy, were only required in the oxytocin group. The carbetocin group reported fewer side effects, most notably lower rates of nausea, vomiting, and hypotension. Conclusion: Carbetocin is a safe and effective alternative to oxytocin for the prevention of PPH. It is associated with reduced need for additional interventions and fewer side effects, making it a favorable option in both vaginal and cesarean deliveries.