Comparison of intravenous carbetocin versus oxytocin infusion on hemodynamics in women undergoing elective Caesarean section in a tertiary care hospital: A prospective observational study

Postpartum hemorrhage (PPH) remains a major cause of maternal morbidity and mortality worldwide. Active management of the third stage of labor (AMTSL) with uterotonic agents such as oxytocin is the standard of care. Carbetocin, a long acting oxytocin analog, has emerged as an alternative with potential benefits, including a longer duration of action and reduced need for additional uterotonic doses.

Spinal anaesthesia, the preferred anaesthetic technique for caesarean sections, induces sympathetic blockade, leading to vasodilation and hypotension. The additional hemodynamic effects of uterotonics, such as tachycardia and hypotension, may further compromise maternal stability. However, there is limited evidence comparing the hemodynamic profiles of oxytocin and carbetocin when administered as intravenous boluses during caesarean section under spinal anaesthesia.

While oxytocin remains as the first line uterotonic agent, its administration can lead to significant hemodynamic disturbances. Carbetocin, due to its prolonged action, may reduce the need for repeated doses and the associated cardiovascular instability. A comparative evaluation of these two drugs in context of spinal anaesthesia is essential to determine the safer option in clinical practice.