Carbetocin vs Oxytocin for Prevention of Postpartum Hemorrhage in Cesarean Delivery: A Systematic Review and Meta-Analysis

Background & Objective: Postpartum Hemorrhage (PPH) is a leading cause of maternal mortality, primarily due to uterine atony. Oxytocin is commonly used to prevent PPH due to its rapid onset and safety. Carbetocin, a long-acting oxytocin analogue, offers a longer duration of action, reducing blood loss and the need for additional uterotonics in cesarean sections. The present study was conducted with aim to compare carbetocin and oxytocin in preventing PPH after elective cesarean delivery.Materials & Methods: This systematic review and meta-analysis was conducted through a comprehensive literature search to identify Randomized Controlled Trials (RCTs), observational studies, and meta-analysis comparing carbetocin and oxytocin for prevention of PPH after cesarean delivery. A meta-analysis was conducted which calculate the pooled risk ratio in terms of postpartum blood loss and postpartum hemoglobin level.Results: In this study, six RCTs with a total of 3,048 patients were included. There was significant difference between carbetocin and oxytocin in postpartum blood loss volume (RR, -47.71; 95%CI, -69.16- (-26.27); P<0.0001; I2=95%). Furthermore, there was no significant difference between carbetocin and oxytocin in postpartum hemoglobin level (RR, -0.03; 95%CI, -0.14-0.08; P=0.62; I2=91%).Conclusion: This meta-analysis indicated that carbetocin is a viable alternative for preventing PPH after cesarean delivery; however, further clinical trials are necessary to validate its effectiveness.