ArticlePakistan journal of medical sciences2026
Carbetocin versus oxytocin during elective cesarean delivery: A randomized double-blind trial.
Article in Pakistan journal of medical sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity following cesarean delivery. This study aimed to compare the effects of carbetocin and oxytocin on intraoperative blood loss during elective cesarean delivery, with secondary evaluation of uterine tone, additional uterotonic requirements, and intraoperative hemodynamic parameters. Methodology: This prospective, randomized, double-blind study was conducted at Van Yuzuncu Yil University Dursun Odabaş Medical Center between 2023 and 2024 and included 100 patients undergoing elective cesarean delivery. Patients were randomly assigned to receive either oxytocin (Group O; 0.6 IU intravenous bolus followed by a 15 IU/h infusion) or carbetocin (Group C; 100 μg administered intravenously over 30-60 seconds). Patients with major obstetric complications, placental invasion disorders, hypertensive disorders of pregnancy, significant cardiovascular or respiratory disease, or hepatic or renal dysfunction were excluded. Intraoperative blood loss, uterine tone, additional uterotonic requirements, and hemodynamic parameters were compared. Results: Baseline demographic characteristics were comparable between groups (p>0.05). Intraoperative blood loss was significantly lower in the carbetocin group than in the oxytocin group (p<0.001). The need for additional uterotonic agents was significantly lower in the carbetocin group both within the first 5 minutes (2% vs. 12%) and throughout surgery (10% vs. 26%) (p<0.05 for both). Uterine tone was significantly higher in the carbetocin group at 5 minutes (p=0.016), whereas higher scores were observed in the oxytocin group at 10 minutes (p=0.034). No clinically significant differences were observed in intraoperative hemodynamic parameters. Conclusion: Although carbetocin and oxytocin demonstrated comparable intraoperative hemodynamic profiles, carbetocin was associated with reduced intraoperative blood loss, improved early uterine tone, and a lower requirement for additional uterotonic agents. Its single-dose administration and favorable safety profile make it a practical and effective uterotonic option for elective cesarean delivery.
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