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

Abstract

In the absence of comprehensive data investigating carbetocin versus misoprostol for reducing postpartum hemorrhage (PPH) during cesarean section (CS), we performed this investigation to compare the efficiency and side events of carbetocin versus misoprostol in the protection and reduction of PPH for women who underwent CS. From inception to September 2022, we depended on searching through various databases for eligible trials involving Cochrane, Web of Science, PubMed, Scopus, and Google Scholar. From the efficacy prospect, we found that carbetocin substantially decreased intraoperative blood loss (p<0.001), hemoglobin/hematocrit levels (p<0.001), and the need for blood transfusion (p=0.002)/additional surgical interventions (p=0.003) than misoprostol. However, we revealed no substantial variation between both drugs for the need for additional uterotonic agents (p=0.08). From the safety prospect, we found that incidences of fever (p=0.002), heat sensation (p=0.007), metallic taste (p=0.01), and shivering (p=0.0002) were lower in carbetocin administration than in misoprostol. However, headache (p=0.34) and palpitation (p=0.11) incidences revealed no substantial variation between both drugs. In conclusion, from the efficacy and safety prospect, for women who underwent CS, carbetocin is more effective and safer in preventing and reducing PPH than misoprostol.

The Effect of Subcutaneous Saline Irrigation on Wound Complications After Cesarean Section: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Cesarean section (CS) is the most prevalent obstetric procedure, accounting for 60% of deliveries in some countries [ 1 , 2 ]. Also, CS prevalence has been swiftly increasing during the last decades, particularly in high-income countries [ 3 , 4 ]. CS can lead to various complications, including surgical site complications, which can be classified as infectious or non-infectious.…”

Efficacy and Safety of Preoperative Melatonin for Women Undergoing Cesarean Section: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials

“…Moreover, CS has been linked to a number of negative effects, such as pain, anxiety, and sleeping problems [ 13 , 14 , 15 ]. Many pharmaceutical therapies have been recommended to reduce these adverse effects and enhance mother and fetal outcomes, including the use of melatonin [ 16 , 17 ].…”