To evaluate the efficacy and safety of carbetocin in the active management of third stage of labour
following emergency cesarean section a clinical study was conducted over a period of six months.
A total of 70 patients who had undergone emergency cesarean section in tertiary level hospital was
enrolled for this study. Emergency cesarean section was defined as delivery because of an
emergency situation in the active phase of labour (e.g. failure to progress, obstructed labour and
fetal distress) then the cesarean section was performed. Each patient obtained a single dose of 100
microgram carbetocin intravenously during cesarean section, immediately after the delivery of the
baby and prior to the delivery of the placenta. Outcome measures such as primary PPH, massive
blood loss, need for additional uterotonic therapy, additional blood transfusion as well as adverse
effects were all documented. Massive blood loss did not occur in any patient. No patient was
needed for immediate blood transfusion. Among the study population 94% patients did not need
any additional uterotonics. No patient had developed fever, arrhythmia, pulmonary edema, tremor,
hypotension and pruritus. Nausea complained only 4.3%, abdominal pain only 5.7%, vomiting only
4.3% and headache only 4.3% which was not statistically significant. No patients had developed
PPH. Carbetocin appeared to be an effective new drug in the active management of third stage of
labour in an emergency cesarean section. Carbetocin has long half-life, which ensures more
effective contraction and less adverse effects. Further research is required to assess whether
carbetocin is superior to conventional uterotonic agents following vaginal delivery.