Comparison of carbetocin and oxytocin in the prevention of atonic post-partum hemorrhage following normal vaginal delivery


  • Aakriti Anurag Department of Obstetrics and Gynecology, MGM Institute of Health Sciences, Navi Mumbai, Maharashtra, India
  • Salomi Singh Department of Obstetrics and Gynecology, MGM Institute of Health Sciences, Navi Mumbai, Maharashtra, India
  • Sushil Kumar Department of Obstetrics and Gynecology, MGM Institute of Health Sciences, Navi Mumbai, Maharashtra, India



Carbetocin, Normal vaginal delivery, Oxytocin, Postpartum hemorrhage


Background: Post-partum hemorrhage is the leading cause of maternal mortality worldwide. Use of uterotonic drugs in active management of third stage of labour has been found to be most effective in prevention of PPH.  Aims and objectives were to compare the efficacy and safety of carbitocin and oxytocin for prophylaxis of post-partum hemorrhage after singleton, term vaginal deliveries.

Methods: Prospective randomized interventional study of 250 women with singleton term pregnancies undergoing vaginal delivery at MGM Women and Children’s Hospital, Kalamboli from May 2021 to May 2022. Participants randomized into 2 groups, group A and B receiving carbitocin and oxytocin respectively. Post-delivery uterine tone, vaginal bleeding, change in Hb and PCV, occurrence of adverse effects used to assess efficacy and safety of both drugs.

Results: Carbetocin was statistically equal to oxytocin in preventing uterine atony and hence PPH, with similar duration of uterotonic action and lesser requirement of other uterotonic drugs. There was no incidence of adverse effects in either group.

Conclusions: Since carbetocin is an effective, room temperature stable uterotonic drug with minimal side effects, it can be beneficial for use in prevention of PPH in rural settings.


Trends in maternal mortality: 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Geneva: World Health Organization; 2019.

Postpartum haemorrhage. National Health Portal of India. Available from: Accessed on 3 May 2022.

Sentilhes L, Vayssière C, Deneux-Tharaux C, Aya AG, et al. Postpartum hemorrhage: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF). Eur J Obstet Gynecol Reprod Biol. 2016;198:12-21.

World Health Organization. WHO recommendations for the prevention and treatment of postpartum haemorrhage. WHO: Geneva: Switzerland; 2012.

ACOG. The Practice Bulletin #183. Postpartum Hemorrhage. 2017. Available from: 2017/10/ACOG_Practice_Bulletin_No_183_Postpartum-Hemorrhage-2017.pdf. Accessed on 3 May 2022.

Jackson Jr KW, Allbert JR, Schemmer GK, Elliot M, Humphrey A, Taylor J. A randomized controlled trial comparing oxytocin administration before and after placental delivery in the prevention of postpartum hemorrhage. Am J Obstet Gynecol. 2001;185(4):873-7.

ICM, FIGO. Joint statement of recommendation for the use of uterotonics for the prevention of postpartum haemorrhage, 2021. Available from: Accessed on 3 May 2022.

Widmer M, Piaggio G, Nguyen TM, Osoti A, Owa OO, Misra S, et al. Heat-stable carbetocin versus oxytocin to prevent hemorrhage after vaginal birth. N Engl J Med. 2018;379(8):743-52.

Malm M, Madsen I, Kjellström J. Development and stability of a heat-stable formulation of carbetocin for the prevention of postpartum haemorrhage for use in low and middle-income countries. J Pep Sci. 2018:e3082.

Rath W. Prevention of postpartum haemorrhage with the oxytocin analogue carbetocin. Eur J Obstet Gynecol Reprod Biol. 2009;147(1):15-20.

Maged AM, Hassan AM, Shehata NA. Carbetocin versus oxytocin for prevention of postpartum hemorrhage after vaginal delivery in high risk women. J Matern Neonat Med. 2015;29(4):532-6.






Original Research Articles