Observational studyBMC pregnancy and childbirth2026
Carbetocin and oxytocin use in emergency cesarean delivery: a prospective observational study of 24-hour bleeding outcomes.
Observational study in BMC pregnancy and childbirth, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07380529 (Comparison of the Effect of Carbetocin Versus Oxytocin in the Prevention of Postpartum Hemorrhage After Emergency Caesarean Section in Antenatal Low-risk Patients), which is not on this map. Not yet cited in PubMed.
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The trial behind it
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Comparison of the Effect of Carbetocin Versus Oxytocin in the Prevention of Postpartum Hemorrhage After Emergency Caesarean Section in Antenatal Low-risk Patients
Who cites it
0 citing papers in PubMed.
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPostpartum hemorrhage remains a major cause of maternal morbidity, and cesarean delivery is associated with greater blood loss than vaginal birth. This study evaluated 24-hour bleeding-related outcomes among antenatally low-risk women who received prophylactic oxytocin or carbetocin after National Institute for Health and Care Excellence (NICE) Category 1-2 emergency cesarean delivery and identified intrapartum factors associated with additional uterotonic use.
methodsThis prospective observational, non-randomized comparative study was conducted between October 2024 and August 2025. Antenatally low-risk women admitted for intended vaginal birth who subsequently required NICE Category 1-2 emergency cesarean delivery received oxytocin 10 IU intravenous (IV) or carbetocin 100 µg IV immediately after delivery. The primary outcome was any additional uterotonic use within 24 h. Secondary outcomes were tranexamic acid use, hemoglobin decrease ≥ 2 g/dL at 24 h, absolute hemoglobin change (ΔHb), and postoperative hemoglobin < 8 g/dL. Multivariable logistic regression was performed for the primary outcome.
resultsA total of 300 women were included, with 150 in each group. Additional uterotonic use occurred in 24.0% (36/150) of the carbetocin group and 33.3% (50/150) of the oxytocin group (p = 0.074). Tranexamic acid use did not differ significantly between groups (18.7% vs. 16.0%, p = 0.542). Hemoglobin decrease ≥ 2 g/dL occurred in 68.0% and 60.0%, respectively (p = 0.149). Mean ΔHb was 2.49 ± 1.13 g/dL in the carbetocin group and 2.38 ± 1.03 g/dL in the oxytocin group (p = 0.388). Postoperative hemoglobin < 8 g/dL occurred in 11.3% and 12.0%, respectively (p = 0.981). In multivariable analysis, induction/augmentation (adjusted OR 1.92, 95% CI 1.07-3.42, p = 0.028) and longer duration of membrane rupture (adjusted OR 1.23 per doubling, 95% CI 1.06-1.43, p = 0.006) were independently associated with additional uterotonic use, whereas uterotonic group was not (adjusted OR for oxytocin vs. carbetocin 1.51, 95% CI 0.90-2.54, p = 0.122).
conclusionsIn this prospective observational non-randomized cohort of antenatally low-risk women undergoing emergency cesarean delivery, no statistically significant between-group differences were observed in additional uterotonic use or predefined 24-hour bleeding-related outcomes. Additional uterotonic use was numerically lower with carbetocin, but the difference was not statistically significant. Induction/augmentation and longer duration of membrane rupture were independently associated with higher odds of additional uterotonic use.
trial registrationClinicalTrials.gov (NCT07380529), first submitted on 18 January 2026. Retrospectively registered.
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