Background: Haemorrhage is a leading cause of maternal death worldwide, accounting for
over 30% of maternal deaths in Africa and Asia. Postpartum bleeding was also 1.6 times
higher in women with preeclampsia than in normotensive women.
Objective: We aimed to prevent postpartum haemorrhage in patients with severe preeclampsia
by using either carbetocin or misoprostol. The primary outcome was postpartum
haemorrhage (blood loss of ≥500 ml) while our secondary outcomes included use of other
uterotonics, blood transfusion, maternal complications and maternal death.
Methods: This prospective, randomized study was done at Department of Obstetrics and
Gynecology, Benha University Hospital, Benha University. 60 pregnant women candidate for
vaginal delivery with severe preeclampsia received either carbetocin or misoprostol after
delivery of the baby.
Results: Carbetocin was superior to misoprostol with lower duration of third stage of labour
(P = 0.036), lower amount of blood loss (P = 0.017) and lower incidence of PPH (P = 0.03). There
was no significant difference in the pre-delivery and the post-delivery haemoglobin concentration
between the two groups with P = 0.061. The need of additional uterotonics and
blood transfusion was higher with misoprostol as compared to cabetocin with P = 0.037 and
0.009, respectively. As regards side effects, misoprostol was associated with shivering and
pyrexia in significantly high number of patients as compared to cabetocin while nausea,
vomiting and headache were more associated with cabetocin.
Conclusions: Carbetocin was more effective than misoprostol when used in women with
severe preeclampsia to prevent postpartum bleeding.
Trial registration: http://clinicaltrials.gov/NCT02086994. |
