Randomized Trial Compares Carbetocin and Oxytocin Hemodynamic Effects in Postpartum Women

Globally, postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality. Uterotonics like oxytocin are standard for PPH prevention and treatment, but their administration can induce significant, albeit transient, hemodynamic changes. With a growing trend towards later childbearing and an increasing prevalence of pre-existing maternal cardiovascular conditions (e.g., congenital or acquired cardiac diseases), these hemodynamic shifts pose a heightened risk. Understanding the precise cardiovascular impact of different uterotonics, particularly longer-acting alternatives like carbetocin, is crucial to optimize patient safety and outcomes in this vulnerable population.

This study is designed as a randomized, double-blind trial comparing the immediate hemodynamic effects of carbetocin 100 µg and oxytocin 5 U against a placebo. Participants will receive one of these interventions. The primary outcome measure focuses on immediate hemodynamic responses, with non-invasive measurements of maternal heart rate, blood pressure, stroke volume, cardiac output, and systemic vascular resistance. These measurements will commence immediately following administration of the study drug and continue over a 1-day timeframe to capture acute changes. The trial also intends to assess secondary outcomes such as estimated blood loss, incidence of PPH (defined as ≥500 mL for vaginal delivery and ≥1000 mL for cesarean section), fall in hemoglobin, and requirement for additional uterotonics.

The provided abstract describes the study design and objectives but does not include any results or findings. Therefore, no specific data, percentages, p-values, or fold-changes from the trial are available at this time. The study aims to measure immediate hemodynamic effects, estimated blood loss, PPH incidence, and changes in hemoglobin, but these outcomes are not reported in the abstract.