The outcome of third stage of labor using carbetocin following vaginal delivery


  • Mahbuba Akhter Jahan Department of Obstetrics and Gynaecology, Mugda Medical College Hospital, Dhaka, Bangladesh
  • Fatema Ashraf Department of Obstetrics and Gynaecology, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh
  • Shah Mohammad Ashek Uddin Bhuiyan Department of Psychiatry, Combined Military Hospital, Dhaka, Bangladesh



Post-partum hemorrhage, Carbetocin, AMTSL, Labour


Background: Primary postpartum hemorrhage (PPH) is a major cause of morbidity and the leading cause of direct maternal death worldwide. Carbetocin, a synthetic analog of oxytocin, has an elimination half-life of 40 minutes compared with 10 minutes for oxytocin,

Methods: This cross-section observational study was conducted at the department of obstetrics and gynaecology, Shaheed Suhrawardy medical college hospital, Dhaka, Bangladesh. The study period was from May 2016 to October 2016. 100 women undergoing normal vaginal delivery were the study subject. A convenient sampling technique was used in this study. Necessary data was collected in the data collection sheet. A standardized deliver mat (Quaiyum's mat) was used before placental removal for measuring blood loss. Carbetocin was an intervention in this study. Statistical analysis was carried out by using the statistical package for social sciences version 19.0 for Windows (SPSS Inc., Chicago, Illinois, USA). The mean values were calculated by frequencies and percentages.

Result: In this study, the majority 54 (54.0%) of patients belonged to age 20-25 years, followed by 30, (30.0%) >25 years. Regarding the occupational status of the patients, it was observed that the majority of 92 (92.0%) patients were housewives. It was observed that the majority of 93 (93.0%) patients had regular menstrual history. Concerning the clinical indices, anaemia was found 69 (69.0%), jaundice 08 (8.0%) and edema 24 (24.0%). Primi para was found 59 (59.0%) and multipara was 41 (41.0%). Primigravida was found 08 (8.0%) and multigravida was 92 (92.0%). In this study, 76 (76.0%) patients had spontaneous delivery, 05 (5.0%) patients had massive blood loss, and 10 (10.0%) patients required further massage.

Conclusions: Carbetocin appears to be an effective new drug in the active management of third-stage labor (AMTSL). A single dose (100 mg) of IV carbetocin is more effective for maintaining adequate uterine tone.


The third stage of labor: Active management following birth. Clinical guideline: King Edward Memorial Hospital. 2021. Available at: Accessed on 18 June, 2023.

Abouzahar C. Antepartum and postpartum hemorrhage. In: Murray CJ, Lopez AD, eds. Health dimension of sex and reproduction. Boston, mass: Harvard University Press. 1998:172-4.

Doles C, Abouzahar C and Stein C. Global burden of maternal hemorrhage in the year 2000. Global burden of disease. Available at: http//www/whoint/health info/statistics/bod–maternalhaemorrhage.pdf. Accessed on 18 June, 2023.

Abalos E. Choice of uterotonic agents in the active management of the third stage of labor: RHL commentary. The WHO Reproductive Health Library-, Geneva: World Health Organization. 2009. Available at: moodle/downloads/Department%20of%20Maternal%20&%20Child%20Health/who%20videos/ Accessed on 3 June 2023.

Ronsmans C, Graham W. Maternal mortality Mortality-who, when, where and why. The Lancet. 2006;368:1189-2000.

Khan KS, Wcjdyla D, Say L, Golmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. The Lancet. 2006;367:1066-74.

McDonald S, Prendiville WJ, Elbourne D. Prophylactic ergometrine-oxytocin versus oxytocin for the third stage of labor (Cochrane Review). In: The Cochrane Library, Issue 1. Oxford: Update Software. 2004.

McDonald SJ, Prendiville WJ, Blair E. Randomised controlled trial of oxytocin alone versus oxytocin and ergometrine in active management of the third stage of labor. BMJ. 1993;307:1167-71.

Su L, Rauff M, Chan Y, Mohamad Suphan N, Lau T, Biswas A et al. Carbetocin versus syntometrine for the third stage of labor following vaginal delivery-a double-blind randomized controlled trial. BJOG. 2009;116:1461-6.

Yuen PM, Chan NS, Yim SF, Chang AM. A randomized double-blind comparison of Syntometrine and Syntocinon in the management of the third stage of labor. Br J Obstet Gynaecol 1995;102:377-80.

Gulmezoglu AM, Forna F, Villar J, Hofmeyr GJ. Prostaglandins for prevention of postpartum hemorrhage (Cochrane Review). In: The Cochrane Library, Issue 1. Oxford: Update Software. 2004.

Chong YS, Su LL, Arulkumaran S. Current strategies for the prevention of postpartum hemorrhage in the third stage of labor. Curr Opin Obstet Gynecol. 2003;16:143-50.

Tasmin SF, Akhtar MJ, Mondal RN, Yeasmin N, Islam GR. Efficacy and Safety of Carbetocin in the Active Management of Third Stage of Labour Following Emergency Caesarean Section. Dinajpur Med Col J. 2016;9(1):45-52.

Leung S, Ng P, Wong W, Cheung T. A randomized trial of carbetocin versus syntometrine in the management of the third stage of labor. BJOG. 2006;113:1459-64.

American College of Obstetricians and Gynaecologists. Quality Assurance in Obstetrics and Gynecology. Washington, DC: ACOG. 1989.

Nirmala K, Zainuddin AA, Ghani NA, Zulkifli S, Jamil MA. Carbetocin versus syntometrine in prevention of post‐partum hemorrhage following vaginal delivery. J Obstetr Gynaecol Res. 2009;35(1):48-54.






Original Research Articles