[CARBETOCIN FOR THE PREVENTION OF POSTPARTUM HEMORRHAGE IN CESAREAN DELIVERIES: A SINGLE CENTER EXPERIENCE AND COST-EFFECTIVE ANALYSIS].

Abstract

Introduction: In recent years, a long-acting Oxytocin analogue, Carbetocin, has been shown to offer clinical advantage over the commonly used Oxytocin.

Aims: To evaluate Carbetocin's clinical and financial benefits compared to Oxytocin in preventing postpartum hemorrhage (PPH) during cesarean delivery.

Methods: We analyzed perinatal outcomes comparing two periods, before (Group 1, Oxytocin era) and after (Group 2, Carbetocin era), when Carbetocin was implemented as a preventive method for PPH during cesarean delivery.

Results: Rates of PPH were significantly lower in Group 2 as compared with Group 1, as evidenced by lower requirements for blood transfusions (1% vs. 4.1%, p=0.003) and post-operative hemoglobin drop of ≥ 3g/dL (5.2% vs. 10.3%, p=0.008). The number of administered packed red blood cells (4 vs. 27 units, p=0.002), delta in hemoglobin level at discharge (1.3 ± 0.9 vs. 1.6 ± 1.2, p=0.002), and duration of hospitalization and re-admission rate were all significantly in favor of Carbetocin use. Financial benefit significantly favored using Carbetocin (ILS 112,237 vs. ILS 125,106.5, respectively, cost-difference of ILS 12,869.5).

Conclusions: Carbetocin has been shown to reduce rates of PPH and provide cost-effective benefits compared to the commonly used uterotonic Oxytocin.

Discussion: Carbetocin showed several advantages compared to Oxytocin in PPH prevention during cesarean section. The clinical and economic research evidence supports the routine implementation of Carbetocin administration to prevent PPH during cesarean delivery.