Oxytocin versus carbetocin for preventing postpartum hemorrhage in patients with polyhydramnios during cesarean delivery: A retrospective cohort study

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OBJECTIVE: This study aimed to compare the effectiveness of oxytocin and carbetocin in preventing postpartum hemorrhage, based on hemoglobin changes between the preoperative and 6-h postoperative periods, operating time, and postoperative shock indices. METHODS: This retrospective cohort study was conducted on singleton pregnancies diagnosed with polyhydramnios that underwent cesarean delivery and had no fetal-placental-genetic or hematological diseases. In the study, oxytocin (n = 78, 52%) and carbetocin (n = 73, 48%) were used for intraoperative postpartum hemorrhage prophylaxis. The primary outcome of the study was a hemoglobin drop between the preoperative period and the sixth hour postoperatively, which served as an objective marker of postpartum blood loss. Secondary outcomes included operation duration, the number of laparotomy sponges and gauze swabs used, shock indices, and the need for additional uterotonics. Additional variables, including gestational diabetes mellitus, fetal macrosomia, gestational age, birth weight, and the deepest vertical pocket of amniotic fluid, were also recorded as demographic and clinical characteristics. RESULTS: The primary outcome showed no significant differences in hemoglobin drop between the preoperative period and the sixth postoperative hour. Among the secondary outcomes, although gestational diabetes mellitus (24% vs. 9.2%, P = 0.018) and macrosomia (13.7% vs. 2.6%, P = 0.011) were more common in the carbetocin group, there was no statistically significant difference between the groups in terms of operation duration, laparotomy sponge usage, shock indices, or the need for blood transfusion. Although not statistically significant, the need for additional uterotonics was almost twice as high in the oxytocin group (23.3% vs. 41%, P = 0.070). CONCLUSION: This research indicated that carbetocin was as effective as oxytocin in reducing postpartum hemorrhage, particularly during a cesarean delivery for those who had been diagnosed with polyhydramnios. Moreover, cases managed with carbetocin require fewer additional uterotonic drugs.