Comparison of the Renal Effects of Carbetoxin and Oxytocin in Hemorrhage Prophylaxis in Elective Cesarean Delivery

Abstract

Objective: The hemodynamic effects and the renal outcome of patients undergoing elective cesarian section with Oxytocin and carbetocin for postpartum haemorrhage prophylaxis are evaluated. Methods: One hundred patients without risk factors for postpartum haemorrhage undergoing elective cesarean delivery, under spinal anaesthesia, were randomly allocated to receive either a single dose of carbetocin (100?g/3 mL) (n = 50) or Oxytocin intravenous injection (3 IU/3 mL) (n=50). The primary outcome was blood loss and hemodynamic effects. The secondary parameter evaluated was the renal effects of drugs. Results: Regarding the hemodynamic effects, intraoperative (243±116.91 ml vs 311.30±130.23 ml, p=0.002) and second-hour postoperative blood loss (24.72 ± 9.43 ml vs 35.54 ± 19.4 ml, p=0.003) were significantly lower in the carbetocin group. At two hours postoperatively, urine osmolality (322.66±211.67 vs 401.45±218.08, p=0.028) was significantly higher in the oxytocin group. Conversely, postoperative urine sodium was higher in the carbetocin group at the twenty four hours in the carbetocin group (51.90±36.74 vs 42.42±41.63, p = 0.004). Conclusion: Carbetocin is easy to use with lower blood loss and less requirement of additional uterotonics compared to Oxytocin. Both drugs cause minimal changes in renal parameters at physiological limits. The renal effects might be far more different with higher doses of both drugs that necessitate further research.