Maternal and Neonatal Outcomes Following Prophylactic Oxytocin versus Carbetocin After Vaginal Delivery: A Prospective Observational Study
DOI:
https://doi.org/10.51168/tgaq6w97Keywords:
carbetocin, oxytocin, postpartum hemorrhage, vaginal delivery, uterotonics, neonatal outcomesAbstract
Background
Postpartum hemorrhage remains a leading cause of maternal morbidity and mortality worldwide. Prophylactic uterotonics are central to active management of the third stage of labour. Oxytocin is widely used after vaginal delivery, whereas carbetocin, a long-acting oxytocin analogue, may provide more sustained uterine contraction and better control of postpartum blood loss.
Objectives
To compare maternal and neonatal outcomes following prophylactic oxytocin versus carbetocin after vaginal delivery.
Methods
This hospital-based cross-sectional comparative study was conducted at RVM Institute of Medical Sciences and Research Centre, Laxmakkapally, Telangana, India, from January 2025 to August 2025. A total of 100 women undergoing vaginal delivery were included. Based on the prophylactic uterotonic administered during the third stage of labour as part of routine clinical care, 50 women received oxytocin and 50 received carbetocin. Maternal outcomes assessed were duration of the third stage of labour, estimated blood loss, postpartum hemorrhage, requirement of additional uterotonics, and adverse effects. Neonatal outcomes included birth weight, Apgar scores, and neonatal intensive care unit admission.
Results
The mean maternal age of the participants was 25.8 ± 3.9 years, and the majority were multiparous women. Baseline demographic and obstetric characteristics were comparable between the two groups. The carbetocin group showed a shorter duration of the third stage of labour and lower mean estimated blood loss than the oxytocin group. Postpartum hemorrhage and the need for additional uterotonics were less frequent among women who received carbetocin. Adverse effects were mild and comparable in both groups. Neonatal outcomes, including birth weight, Apgar scores, and NICU admission, did not differ significantly between the groups.
Conclusion
Carbetocin demonstrated better maternal haemostatic outcomes than oxytocin after vaginal delivery, while neonatal outcomes remained comparable.
Recommendation
Carbetocin may be preferred for postpartum hemorrhage prophylaxis after vaginal delivery, especially in women with anticipated increased bleeding risk.
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Copyright (c) 2026 Dr Akula Swaroopa Rani, Dr Manjula D, Dr Alekya A, Dr Prashanth Kumar Patnaik (Author)
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