Purpose. To optimize methods for the prevention of obstetric bleeding in high-risk pregnant women with abdominal delivery using the uterotonics. Material and methods. It analyzed the results of 79 pregnant women management with a high risk of obstetric bleeding who underwent delivery by caesarean section: group 1 (n = 35) standard protocol for the prevention of obstetric bleeding (oxytocin) was used; group 2 (n = 44) – carbetocin was used to prevent bleeding. The frequency of transferring patients to the so-called major operations (ligation of the internal iliac artery, the imposition of compression sutures on the uterus, supravaginal amputation of the uterus), as well as the frequency of gravitational blood surgery procedures were evaluated. Side effects were recorded against the background of the use of various options for drug support of surgical delivery. Results. It was found that the use of carbetocin as a means of preventing bleeding in women undergoing abdominal delivery contributes to a statistically significant decrease in the total frequency of bleeding after surgery compared with the use of oxytocin (1.8 times), along with a decrease in the volume of bleeding, while the frequency bleeding with a volume of more than 1500 ml decreases 2.5 times. The use of carbetocin for the prevention of bleeding in women who undergo a cesarean section contributes to a 3.1 times lower frequency of switching to performing ‘major’ operations in this category of patients compared to the use of oxytocin, as well as a decrease in the relative number of gravitational surgery procedures performed in 11,2 times. The use of carbetocin as a means of preventing bleeding in women undergoing abdominal delivery is accompanied by a lower incidence of side effects compared to the use of oxytocin (1.8 times). Conclusion. Carbetocin is one of the myometrial drugs that should be considered as a potentially important tool for improving labor outcomes.

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