Comparative Study of Intravenous Carbetocin Versus Rectal Misoprostol for Prevention of Postpartum Haemorrhage in Third Stage of Labour in Vaginal Delivery

Dr Pragya Tiwari

Abstract: Background: Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality worldwide, particularly in low- and middle-income countries. Active management of the third stage of labor (AMTSL) using effective uterotonics is crucial for PPH prevention. Oxytocin, though effective, has storage and stability limitations, prompting evaluation of alternatives such as carbetocin and misoprostol. This study aimed to compare the efficacy and safety of intravenous carbetocin versus rectal misoprostol in preventing PPH among low-risk women undergoing vaginal delivery. Methods: This prospective, randomized comparative study was conducted in the Department of Obstetrics and Gynecology at Dr. Rajendra Prasad Government Medical College, Kangra at Tanda. One hundred women with uncomplicated singleton term pregnancies were randomly assigned to two groups of 50 each. Group A received 100 ?g of intravenous carbetocin at delivery of the anterior shoulder, while Group B received 800 ?g of rectal misoprostol at crowning. Blood loss was measured using a calibrated drape and by weighing blood-soaked materials up to two hours postpartum. Hemoglobin and hematocrit levels were assessed pre- and post-delivery. Statistical analysis was performed using t-test and Chi-square test, with p < 0.05 considered significant. Results: The mean blood loss was significantly lower with carbetocin (214.3 ± 55.7 mL) compared to misoprostol (322.2 ± 74.8 mL; p = 0.001). The incidence of PPH (?500 mL) and uterine atony were also lower with carbetocin (2% vs. 12% and 2% vs. 16%, respectively; p = 0.03). The mean fall in hemoglobin and hematocrit levels was significantly less in the carbetocin group (p = 0.003). Both drugs were well tolerated, with only mild, transient side effects observed. Conclusion: Intravenous carbetocin is significantly more effective than rectal misoprostol in reducing postpartum blood loss and preventing PPH in low-risk vaginal deliveries, with a comparable safety profile. Given its prolonged uterotonic effect and heat stability, carbetocin represents a superior option for AMTSL, although its cost may limit widespread use.

Keywords: postpartum hemorrhage, carbetocin, misoprostol, vaginal delivery, uterotonic drugs

How to Cite?: Dr Pragya Tiwari, "Comparative Study of Intravenous Carbetocin Versus Rectal Misoprostol for Prevention of Postpartum Haemorrhage in Third Stage of Labour in Vaginal Delivery", Volume 15 Issue 4, April 2026, International Journal of Science and Research (IJSR), Pages: 792-795, https://www.ijsr.net/getabstract.php?paperid=SR26405202248, DOI: https://dx.dx.doi.org/10.21275/SR26405202248

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