Advantages of Intramyometrial Carbetocin and Oxytocin in Cesarean Delivery: Preventing PPH While Reducing Ergometrine Use

Background: Postpartum hemorrhage (PPH), primarily caused by uterine atony, remains a leading contributor to maternal mortality. Carbetocin, a long-acting oxytocin analogue, provides sustained uterine contraction with a favorable side effect profile. Intramyometrial administration enhances drug efficacy by ensuring rapid and targeted uterine action. Objectives: To assess the efficacy of intramyometrial Carbetocin and Oxytocin in preventing PPH during cesarean sections by evaluating intraoperative blood loss, uterine tone, and the requirement for Ergometrine. Methods: A prospective comparative study was conducted on 58 patients undergoing cesarean section at Ad-din Sakina Medical College Hospital and Kings Hospital, Jashore, from January 2023 to December 2023. Participants were randomized into two equal groups: Group I received I/V oxytocin and intramyometrial Carbetocin and Oxytocin; Group II received intravenous Oxytocin only. Outcomes measured included estimated blood loss, uterine tone, need for Ergometrine, and side effects. Data were analyzed using SPSS v23. Results: The mean age of participants was 28.9 ± 4.1 years, with previous cesarean being the most common indication (41.4%). Ergometrine was required in 20.7% of cases, all from Group II. In Group I, 58.6% experienced blood loss <500 ml and 79.3% maintained stable vitals. Uterine contraction was adequate for 10–20 minutes in 58.6%. Minimal side effects were observed, with 77.6% reporting none. Conclusion: Intramyometrial administration of Carbetocin and Oxytocin in cesarean delivery significantly reduces blood loss and eliminates the need for Ergometrine, ensuring better uterine tone and maternal stability with minimal adverse effects.