EJMS

Abstract

Background: Untreated retained placenta is the second most common cause of postpartum hemorrhage. Nowadays pharmacological management of retained placenta seems to be a good alternative to surgical intervention. Carbetocin which is an analogue of oxytocin is a drug indicated for controlling postpartum hemorrhage Aim: To compare carbetocin and oxytocin in terms of efficacy in the management of retained placenta Methods: We conducted our search in the different online databases for eligible clinical trials excluding observational studies. We used the Cochrane risk of bias tool to perform the quality assessment of the included trials. The assessed outcomes include total blood loss, duration of the third stage of labour, pre-delivery hemoglobin, post-delivery hemoglobin, manual removal of placenta, blood transfusion, additional uterotonic agents, placenta expelled spontaneously, adherent placenta, and successful expulsions. Results: We included four trials in our meta-analysis. Our results yielded an overall favoring of the carbetocin group over the oxytocin group in terms of total blood loss (MD = -119.12, 95% CI [-130.76, -107.48], p<0.001), duration of the third stage of labor (MD = -4.44 [-7.11, -1.78], p= 0.001), blood transfusion (RR = 0.46 [0.21, 1.02], p=0.05), the need for additional uterotonic drugs (RR= 0.30 [0.20, 0.44], p<0.001), placenta expelled spontaneously (RR= 1.14 [1.02, 1.26], p=0.02), and the manual removal of placenta (RR= 0.70 [0.50, 0.98], p=0.04). However, both drugs showed similar results regarding adherent placenta (RR= 0.46 [0.14, 1.44], p=0.18), successful expulsion (RR= 1.09 [0.94, 1.26], p=0.27), pre, and post-delivery hemoglobin. Conclusion: To conclude, we found that carbetocin is associated with positive and promising results than oxytocin in the management of retained placenta and it is ass