A Comparative Study of the Cardiovascular Effects of a Lower Dose of Heat-Stable Carbetocin Versus the Standard Dose in the Prevention of Postpartum Hemorrhage During Elective Cesarean Delivery: A Single-Blinded, Randomized, Parallel-Group Trial

Abstract

Introduction: Oxytocin is a uterotonic drug that acts on receptors in the myometrium, causing uterine contractions. However, oxytocin receptors are also present in other organs, including the myocardium. Heatstable carbetocin, a long-acting analog of oxytocin, is also known to act on these oxytocin receptors. As carbetocin has a long half-life of 40 minutes, its duration of action on the myocardium may be relatively longer than that of oxytocin. Therefore, this study aimed to study the cardiovascular effects of using a lower dose of carbetocin (50 mcg) compared to the standard dose (100 mcg) during elective cesarean delivery.Materials and methods: A total of 212 full-term pregnant women were randomized into two groups: group I received 50 mcg of intravenous carbetocin, and group II received 100 mcg of intravenous carbetocin. Heart rate, blood pressure (BP), oxygen saturation, electrocardiogram changes, and pre-and postoperative (12 hours after cesarean delivery) high-sensitivity cardiac troponin I levels were compared between the groups.Results: No statistically significant differences were observed between the groups with respect to heart rate, BP, electrocardiogram changes, or difference in pre-and postoperative high-sensitivity cardiac troponin I levels (p > 0.05).Conclusion: Carbetocin's cardiovascular effects were similar in both groups. None of the participants had adverse cardiovascular effects from the drug, and there were no differences in cardiovascular effects between the groups.