Carbetocin in the Prevention of Postpartum Hemorrhage after Vaginal Birth: A Systematic Review and Meta-Analysis.

Objective: To evaluate the safety and efficacy of carbetocin for reducing blood loss following vaginal delivery (VD). Methods: Databases, including MEDLINE, Scopus, Web of Science, EMBASE, Cochrane Library, Scopus, and clinical trial registries, were screened from inception to November 2024 using keywords related to carbetocin, postpartum hemorrhage (PPH), postpartum blood loss, and VD. Only randomized controlled trials included participants who underwent VD, totaling 19 studies including 69,884 women. Seventeen studies were published in English, one in Spanish, and one in Chinese. The extracted data included study location, number of participants and characteristics, intervention (including dose, route, and timing of administration), primary and secondary outcome parameters, and trial registration details. Results: Thirteen studies with 64,731 participants compared carbetocin to oxytocin. Blood loss in the first 24 h was assessed in ten trials (7403 participants), which reported a mean difference ( Conclusion: Carbetocin administration was associated with reduced blood loss during the first 24 h after VD, a less severe decrease in postpartum hemoglobin levels, and a reduced need for additional uterotonics compared with oxytocin administration. Registration: Registration number CRD42023492407.