Carbetocin vs. Misoprostol Effectiveness and Safety Compared for Postpartum Hemorrhage Prevention in High-Risk Vaginal Deliveries

Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality worldwide, particularly among women with known risk factors. Uterotonic agents are routinely administered after vaginal delivery to prevent excessive bleeding. Carbetocin, a long-acting oxytocin analogue, and misoprostol are both utilized for this purpose, but comparative data specifically in high-risk vaginal deliveries remain limited. This gap necessitates research to determine the optimal agent for improving maternal outcomes.

This prospective randomized study enrolled 200 women with risk factors undergoing vaginal delivery at Galilee Medical Center. Participants were randomized to receive either intravenous Carbetocin or rectal misoprostol for postpartum hemorrhage (PPH) prevention. The primary endpoint is the incidence of PPH. Secondary outcomes include the need for additional uterotonic agents or surgical interventions, changes in hemoglobin levels, blood transfusion requirements, and maternal adverse effects.

This abstract outlines the methodology and objectives of a prospective randomized study, but it does not present specific findings or numerical results. The trial, which has completed enrollment with 200 participants, is designed to rigorously compare the effectiveness and safety profiles of Carbetocin and misoprostol in preventing postpartum hemorrhage (PPH) among women with risk factors undergoing vaginal delivery. Primary outcomes will focus on the incidence of PPH, while secondary outcomes will quantify the need for additional uterotonic agents or surgical interventions, assess changes in hemoglobin levels, track blood transfusion requirements, and document maternal adverse effects.

The specific comparative data on Carbetocin versus misoprostol in this high-risk population are crucial and are expected to be reported upon study completion.