Carbetocin versus Misoprostol in Reducing Blood Loss during Cesarean Section in low risk patients. A Randomized Controlled Trial

Abstract

Aim: This study aimed to compare the use of misoprostol to carbetocin in reducing blood loss during cesarean section in low risk patients. Materials and Methods: This randomized controlled study enrolled 300 patients who were eligible. 150 women received carbetocin100ug i.v intra-operative immediately after extraction of the fetus during cesarean section (group A). They were compared to 150 women who received misoprostol 600ug rectally immediately before sterilization during caesarean section (group B). Results: There is significant difference in intraoperative uterine atony [3 (2.0%) vs 11 (7.3%) P < 0.02] and the need for blood transfusion [2 (1.2%) vs 10 (6.7%) P > 0.018] and surgical hemostatic measures as uterine artery ligation and uterine compression sutures [0.00 vs 3.00 (2%) P < 0.00 and 0.00 vs 12.00 (8%) P < 0.00] were higher in misopristol group. Also, the need for other uterotonic drugs was significantly higher in misopristol group (10.0 ± 0.0 vs 13.15 ± 5.28, P < 0.001 and the difference in hemoglobin and hematocrit values before and after delivery were slightly higher in misopristol group with no statistical significance (

The Effect of Carbetocin versus Misoprostol versus Ergometrine for Controlling Bleeding after Cesarean Section in Primigravidae

“…We found that carbetocin is superior to misoprostol in reducing blood loss in CS in primigravida. In agreement with our study, Moustafa et al [17] concluded that intravenous therapy infusion of 100 ug carbetocin is more effective in managing blood loss during CS than 600ug rectal misoprostol.…”

“…In the present study, the need for blood transfusion was significantly lower in the carbetocin group. This was in agreement with Ali et al [25] and Moustafa et al [17] who found that carbetocin decreases the need for blood transfusion after cesarean.…”

“…Many studies worldwide compared misoprostol to oxytocin [14,15] and carbetocin to oxytocin [11,16] in reducing blood loss during cesarean section. However, few studies compared carbetocin to misoprostol in reducing blood loss during cesarean section [17].…”

Efficacy and Safety of Carbetocin Versus Misoprostol in Cesarean Section: A Systematic Review and Meta-Analysis

“…Although the length and trial settings varied, all included RCTs were conducted in Egypt. Most RCTs [ 14 , 21 , 23 ] used misoprostol per rectum except one [ 22 ], which used it sublingually. Also, three RCTs [ 14 , 21 , 22 ] operated on patients under spinal anesthesia, and one RCT [ 23 ] performed on their patients under general anesthesia.…”

“…Most RCTs [ 14 , 21 , 23 ] used misoprostol per rectum except one [ 22 ], which used it sublingually. Also, three RCTs [ 14 , 21 , 22 ] operated on patients under spinal anesthesia, and one RCT [ 23 ] performed on their patients under general anesthesia. Table 1 and Table 2 depict a summarization of the baseline features of the eligible articles.…”