Comparing oxytocin alternatives for postpartum hemorrhage prevention in vaginal and caesarean births: a systematic review and meta-analysis.

BACKGROUND: In this systematic review and meta-analysis, we aimed to explore the availability of alternatives to oxytocin for preventing postpartum haemorrhage (PPH) during vaginal births (VB) and caesarean births (CB). METHODS: We followed the Cochrane guidelines for the review, and reported the results using the PRISMA guidelines. Using a thorough search strategy, we retrieved original articles from SCOPUS, PubMed, Web of Science, and the Cochrane Library from January 2015 to February 2025. We analyzed the RCTs to compare Tranexamic Acid (TXA), carbetocin, and misoprostol with oxytocin for preventing PPH in both vaginal and caesarean births. The review's protocol has been officially registered with PROSPERO under the identifier CRD420251002602. RESULTS: = 96%), respectively. CONCLUSION: Considering the substantial heterogeneity and mostly non-significant pooled results, the current findings should be viewed as indicative rather than conclusive. Further rigorous, well-designed randomized controlled trials are necessary to better define their effectiveness, optimize dosing, and identify patient groups most likely to benefit.