Tashrin Begum, Choudhury Taslima Nasrin, Ummae Tania Nasrin, Afroza Sultana, Hafiza Farzana and Bappi Das
Objective: To compare the effectiveness of oxytocin and carbetocin to prevent primary PPH in hypertensive disorder of pregnancy.
Methods: It was a randomized single blind controlled clinical trial, which includes 100 women with hypertensive disorders of pregnancy according to inclusion and exclusion criteria who admited in the Department of Obstetrics and Gynaecology, Institute of Child and Mother Health, (ICMH), Matuail from March 2015 to February 2016. There were two groups by randomization by computer generated code number. Fifty cases were included in each group. Group I received oxytocin and group II received carbetocin for active management of 3rd stage of labour. Main outcome measures estimated were blood loss, change in hemoglobin level before and after delivery, occurrence of PPH. Data were analyzed by computer based software SPSS windows 20.0 version.
Results: This study shows majority of the patients belonged to 21-25 years age group. In management of 3rd stage of labour four (8%) of patients of carbetocin group were required additional uterotonic but in oxytocin group additional uterotonics were required for 82% patients. Fourteen percent needed for blood transfusion in oxytocin group but no need for blood transfusion in carbetocin group. Average blood loss were higher in oxcytocin group than carbetocin group which was 592 ml vs 348 ml. In very few patients had developed side effects like nausea in 4% and abdominal pain in 6% of carbetocin group also nausea in 4%, headache in 2% and abdominal pain in 8% in oxytocin group.
Conclusion: This study showed primary postpartum haemorrhage was less and very few patients needed additional uterotonics in carbetocin group. But majority patients needed additional uterotonics in oxytocin group. There was higher blood loss in oxcytocin group than carbetocin group. So carbetocin is an appropriate alternative to oxytocin for the prevention of primary PPH in hypertensive disorder of pregnancy.
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