A systematic review and meta‐analysis of randomized trials comparing carbetocin to oxytocin in prevention of postpartum hemorrhage after cesarean delivery in low‐risk women

• Published in: The journal of obstetrics and gynaecology research 2025-01, Vol.51 (1), p.e16194-n/a
• Main Authors: Maged, Ahmed M., El‐Goly, Nour A., Turki, Doaa, Bassiouny, Nehal, El‐Demiry, Nihal
• Format: Article
• Language: English
• Subjects: blood loss; Blood transfusion; Blood transfusions; carbetocin; cesarean delivery; Cesarean section; Cesarean Section - adverse effects; Clinical trials; Data collection; Female; Hemoglobin; Hemorrhage; Hormones; Humans; Meta-analysis; Misoprostol; Oxytocics - administration & dosage; Oxytocics - adverse effects; Oxytocin; Oxytocin - administration & dosage; Oxytocin - adverse effects; Oxytocin - analogs & derivatives; Postpartum; postpartum hemorrhage; Postpartum Hemorrhage - prevention & control; Postpartum period; Pregnancy; Randomized Controlled Trials as Topic; Side effects
• ISSN: 1341-8076; 1447-0756; 1447-0756
• DOI: 10.1111/jog.16194

Objectives To evaluate the efficacy and safety of Carbetocin compared to oxytocin in prevention of postpartum hemorrhage (PPH) after low‐risk cesarean delivery (CD). Search Strategy Screening of Medline, Web Of Science, Scopus, Google scholar, and clinical trials registry till January 2024 using the key words related to carbetocin, blood loss, PPH, Cesarean section and their MeSH terms was done. Selection Criteria This study included all RCTs conducted on women with low risk for developing PPH after CD and compared the administration of carbetocin to oxytocin without any language limitation. These studies compared carbetocin to oxytocin alone or oxytocin combined with misoprostol. The review included all doses and routes of carbetocin and oxytocin administration. Data Collection and Analysis The extracted data included study settings, the participants' size and characteristics, intervention details of both the study and control groups especially data about the dose route and timing of drug administration, the outcome parameters and trial registration details The reported outcomes included the requirement of additional uterotonic agents or blood transfusion, the difference between preoperative and postoperative hemoglobin, the occurrence of PPH, blood loss and drug adverse effects. Main Results Seventeen studies including 3667 participants were included. The need for additional uterotonic agents was evaluated in 14 studies with 3154 participants and revealed an OR of 0.53 with 95% CI of 0.39 and 0.72 (p