In women undergoing cesarean section, Carbetocin is not superior in the prevention of postpartum blood loss when compared to Oxytocin.

A prospective, randomized clinical trial was conducted to evaluate the effectiveness of 3 different uterotonic agent regimens in managing postpartum hemorrhage (PPH) in females who were planning to undergo cesarean section (C-section).

Women participating in the study were randomized into 3 groups: Group I (n = 52) received Oxytocin alone, Group II (n = 52) received a combination of Oxytocin and intrauterine Misoprostol, and Group III (n = 52) received Carbetocin alone.

The major endpoints assessed included PPH, which was measured by comparing the alterations in preoperative and postoperative hemoglobin levels, along with hematocrit and intraoperative blood loss.

Patients in Group III exhibited the blood loss characteristics, with the lowest alterations in hemoglobin and hematocrit concentration, as well as reduced intraoperative blood loss and the need for extra hemostatic uterine sutures and uterotonics. However, when assessing blood loss parameters, all groups were similar. Notably, Group III experienced the highest blood loss ratio, surpassing 1000 mL.

In the case of Oxytocin and intrauterine Misoprostol combination, the absolute risk reduction (ARR) was 3.8%, with a relative risk (RR) of 1.18 and a number needed to treat (NNT) of 26. For Carbetocin, the ARR stood at 5.8%, with an NNT of 17 and a RR of 1.27.

Carbetocin's effectiveness in preventing PPH in women undergoing C-section did not appear to surpass that of Oxytocin, which remained a highly effective option for PPH prevention.