The minimum Effective Dose of Carbetocin In Preventing Postpartum Hemorrhage In Cesarean Delivery : A Factorial Randomized Controlled Trial.

Postpartum haemorrhage (PPH) is the leading cause of maternal mortality and morbidity. Most common cause of PPH is failure of adequate uterine contractions or uterine anomalies. Administration of uterotonic drugs during cesarean section diminishes the risk of PPH. Carbetocin is a synthetic analogue of oxytocin with 4-10 times longer half life than oxytocin and it is heat stable.  The recommended dose of Carbetocin is 100mcg IV by SOGC as uterotonic in cesarean deliveries. Am doing a study to find the least  dose of carbetocin that can produce effective and satisfactory uterine contractions in parturients undergoing cesarean section under spinal anaesthesia. They are allotted into five groups to receive five different doses of carbetocin namely Group A 100mcg, Group B 80mcg, Group C 60mcg, Group D 40mcg, Group E 20mcg.The obstetrician will assess the uterine contraction as satisfactory or unsatisfactory at 2minutes, 5minutes, 10minutes after carbetocin administration. If at 5minutes uterine contraction is inadequate , the patient will be managed according to FIGO Recommendations 2022.