Effectiveness of carbetocin versus oxytocin in the treatment of postpartum hemorrhage: a systematic review

Background: Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality, especially in low- and middle-income countries. Oxytocin and carbetocin are the main recommended treatments, but uncertainty remains about which is more effective in reducing maternal mortality and blood loss. Objective: To compare the effectiveness of carbetocin versus oxytocin in the treatment of PPH through a systematic review of observational studies examining the various risk factors and reductions in blood loss. Methods: A systematic review will be conducted following the PRISMA guidelines. Databases such as PubMed, SciELO, ScienceDirect, and Cochrane will be searched for studies directly comparing the administration of carbetocin and oxytocin in women with PPH. Studies will be selected using the Rayyan platform, and their quality will be assessed using the RoB 1 and RoB 2 tools. Expected results: The review is expected to determine whether carbetocin is more effective than oxytocin in reducing maternal mortality and blood loss. Conclusion: This systematic review will provide an evidence-based overview of the comparative efficacy of these treatments, informing clinical practice in the management of PPH, especially in resource-limited settings