INJECTION CARBETOCIN VERSUS INJECTION OXYTOCIN IN VAGINAL DELIVERY FOR PREVENTION OF POST-PARTUM HEMORRHAGE

Approximately one-fourth of all maternal deaths are caused by postpartumhaemorrhage (PPH), which has a prevalence of 6% worldwide and is a significantcontributor to maternal mortality and morbidity. “PPH typically manifestswithin 24 hours of delivery, however it can also appear up to 12 weeks afterthe deliveryâ€. PPH has reportedly became more prevalent and severe in a numberof industrialised nations . Up to 80% of PPH cases are caused by uterineatony , which is also the most common cause of PPH. As a result, it iscrucial to timely and effectively induce the uterine contractions soon afterthe childbirth.

It is seen that when active management of third stage of labour is done,probability of severe primary PPH, need for transfusion, and subsequentuterotonic therapy are all decreased . The most used and efficientuterotonic drug for preventing PPH is oxytocin . However, because to itsearly onset and short duration of action, it is best administered to initiatepersistent uterotonic activity.

Oxytocin often requires several doses or other uterotonics to arresthaemorrhage which adds to various side effects and increase in expenditure oftreatment.

In contrast to oxytocin, carbetocin(octapeptide) is a long-acting synthetic analogue of oxytocin (nonapeptide)which requires only single dose administration.  .Even after a single bolusinjection of carbetocin, the uterotonic effects lasts for several hours.

Currently oxytocin is most frequently used as agent of first choiceafter vaginal delivery. Due to its short half-life (4 to 10 minutes), itrequires continuous or frequently repeated administration. More recentlycarbetocin has been developed as a long acting oxytocin agonist and whenadministered it results in a sustained uterine contraction.

There is currently less data to evaluate the efficacy of carbetocin inwomen undergoing vaginal delivery for prevention of post-Partum haemorhage,hence we aim to do this study.

Ø Study Type : ComparativeObservational Study

Ø Estimated sample size: 200

Ø Allocation:  Randomized

Ø Masking: Single(Investigator)

Ø Primary Purpose: Treatment

Placeof study: Department of Obstetrics and GynecologyJNMC, AVBRH, DMIHER (Deemed University), Wardha.

Durationof Study: 2023-2025

Studydesign: Comparative Observational Study

Samplesize: 200