Introduction and objective:
Postpartum haemorrhage (PPH) is the leading preventable cause of maternal mortality, with uterine atony as its primary cause in caesarean sections. Compared to standard oxytocin, carbetocin offers a more sustained uterotonic effect. The aim of the study is to compare the clinical efficacy of prophylactic carbetocin versus oxytocin in high-risk caesarean deliveries.

Material and methods:
This prospective, randomized controlled study was conducted with 100 pregnant women presenting with high-risk factors for PPH (multiple gestation, macrosomia, polyhydramnios, prolonged labour, history of uterine atony). The cases were divided into two equal groups: the control group (n=50) received a standard oxytocin infusion, and the study group (n=50) received a single dose (100 µg) of carbetocin prophylaxis. Demographic characteristics, postoperative laboratory parameters, the need for additional uterotonics, and the requirement for blood transfusions were compared between the groups.

Results:
The need for additional uterotonics (oxytocin) was found to be significantly lower in the carbetocin group at 4%, compared to 30% in the standard oxytocin group (p<0.01). The requirement for blood transfusion was 4% in the carbetocin group and 26% in the control group (p>0.05).

Conclusions:
Single-dose carbetocin is significantly more effective than standard oxytocin at for maintaining uterine contraction and decreasing the need for additional uterotonics in high-risk cesarean deliveries. The results indicate that carbetocin is a robust alternative for optimizing postpartum haemorrhage (PPH) management and reducing clinical workload.