Carbetocin versus oxytocin for the prevention of postpartum hemorrhage: A meta-analysis of randomized controlled trials in cesarean deliveries

Carbetocin at elective caesarean section: a sequential allocation trial to determine the minimum effective dose in obese women

“…Carbetocin is a synthetic long‐acting oxytocin analogue that binds to oxytocin receptors in the myometrium . The prophylactic use of carbetocin at caesarean section is associated with a significant reduction in the need for additional uterotonics when compared with oxytocin, and may be superior and more cost effective than conventional uterotonic drug combinations for the prevention of postpartum haemorrhage . The drug manufacturer, the Society of Obstetricians and Gynaecologists of Canada (SOGC) and the World Health Organization (WHO) recommend a dose of 100 μg at caesarean section based on demonstrated efficacy in clinical trials .…”

Comparison of carbetocin and oxytocin infusions in reducing the requirement for additional uterotonics or procedures in women at increased risk of postpartum haemorrhage after Caesarean section

“…Notably, carbetocin and oxytocin have been shown to exert differential effects on postpartum haemorrhage and related changes in patients undergoing Caesarean section for different indications. 6 When we analysed individual risk factors for postpartum haemorrhage, we found significant reductions in the use of additional uterotonics or procedures and in the rate of postpartum haemorrhage in women with major placenta praevia and in women with multiple pregnancies. We also observed a significant reduction in total blood loss in the emergency Caesarean section group for both women with major placenta praevia and women with multiple pregnancies.…”

“…3 In 2018, a meta-analysis involving seven trials showed that carbetocin was effective in reducing the use of additional uterotonics, as well as in reducing postpartum haemorrhage and transfusion, when used during Caesarean section. 6 A recent meta-analysis involving 30 trials has shown that carbetocin is effective in reducing the need for additional uterotonic use and postpartum blood transfusion in women at increased risk of postpartum haemorrhage after Caesarean delivery. 7 Another recent meta-analysis involving nine trials has shown that carbetocin is associated with a 53% reduction in the need for additional uterotonics, when compared with oxytocin, at the time of elective Caesarean delivery.…”

“…8 The use of carbetocin has been recommended in elective Caesarean sections by the Royal College of Obstetricians and Gynaecologists 9 and the Society of Obstetricians and Gynaecologists of Canada. 10 In one meta-analysis, 6 heterogeneity was found in the use of dose of oxytocin, which ranged from 2 IU to 10 IU of bolus oxytocin to infusions of 20 to 30 IU, and in the indications for Caesarean section. In a study of 1568 Chinese women who underwent Caesarean section for different indications, carbetocin and oxytocin were found to have differential effects on postpartum haemorrhage and related changes.…”

“…In a study of 1568 Chinese women who underwent Caesarean section for different indications, carbetocin and oxytocin were found to have differential effects on postpartum haemorrhage and related changes. 6 However, to the best of our knowledge, most studies have compared the differential therapeutic effects of carbetocin and oxytocin in the general population or in low-risk groups. Carbetocin is a relatively more expensive drug than conventional synthetic oxytocin (eg, Syntocinon), and there has not been sufficient evidence from cost-effectiveness studies to support its use in all patients.…”