Prophylactic carbetocin versus oxytocin following vaginal delivery among women with high risk for postpartum hemorrhage: A before‐and‐after study

INTRODUCTION: Data with a high level of evidence is lacking on the use of prophylactic uterotonic drug following vaginal delivery to prevent postpartum hemorrhage (PPH) among women who were considered high-risk for PPH. Our main objective was to compare the effectiveness of prophylactic carbetocin versus oxytocin in preventing PPH after vaginal delivery among women at high risk. MATERIAL AND METHODS: We conducted a retrospective before-and-after single-center comparative study, including all high-risk women after vaginal births. Two consecutive 14-month periods were compared, where the prophylactic methods to prevent PPH differed: oxytocin (5 IU IV) versus carbetocin (100 μg IV) given immediately after vaginal delivery. High-risk women were defined by at least one of the following criteria: previous PPH (blood loss ≥500 mL), antenatal suspicion of macrosomia (estimated fetal weight >90th p), twin pregnancy, repeated cervical ripening methods, polyhydramnios, multiparity (≥4), and rapid labor (