The efficacy of Intravenous Carbetocin versus Intravenous Oxytocin in active management of Third stage of labour in women delivering vaginally - A randomised controlled trial

Introduction: Active management of the third stage of labor (AMTSL) is a critical intervention for Postpartum hemorrhage (PPH) prevention which is commonly caused by uterine atony. The current standard therapy for the prevention of PPH is oxytocin but it presents unsatisfactory real-world efficacy because of its sensitivity to heat and insufficient active ingredients or impurities, however, an oxytocin analog heat-stable carbetocin  does not require cold-chain transport and storage. Therefore, this study aims to determine the efficacy of Intravenous (IV) carbetocin in the AMTSL in vaginal deliveries.

Methodology: A total of 184 antenatal women will be randomized by computer-generated randomization and a sequentially numbered, sealed opaque envelope method will be used for allocation in this single-blinded parallel-group randomized controlled trial. Group A (study group) will receive an injection of carbetocin 100 mcg IV slow bolus as a single dose and Group B (control group) will receive 10 IU IV infusion of oxytocin after the delivery of the baby within 1 minute and before the delivery of the placenta.

Result: The blood loss in each group will be calculated using a quantitative method of measuring blood loss. The use of other uterotonics to prevent PPH will be taken into account. The patient’s hemoglobin and need for blood transfusion will be noted on day 3 following the vaginal delivery. The statistical analysis will include descriptive and inferential analysis to determine the significant difference.

Conclusion: The present study will be comparing and concluding the efficacy of IV carbetocin with IV oxytocin in the AMTSL and PPH in vaginal deliveries. This will explore the implication of a much more effective drug that will assist in the prevention of PPH and reduce mortality and morbidity during vaginal deliveries.