Comparación entre oxitocina y carbetocina en la prevención de hemorragia postparto. Revisión sistemática

Abstract

Title: Comparison of Oxytocin and Carbetocin in the Prevention of Postpartum Hemorrhage: A Systematic Review. Background: Postpartum hemorrhage (PPH) is a leading cause of maternal mortality globally, especially in low- and middle-income countries. Oxytocin and carbetocin are uterotonics widely used for their prevention; however, the need to compare their efficacy and safety remains. Methodology: Review conducted following PRISMA 2020 guidelines, registered in PROSPERO CRD420251070606. The search was performed in PubMed and Taylor & Francis databases (2020-2025). Eligibility criteria included clinical/comparative studies in humans, excluding reviews and case reports. Bias assessment was performed using RoB 2 and JBI tools. A meta-analysis was not conducted due to heterogeneity; the results were synthesized narratively. Results: Eleven studies were included (nine clinical trials, one cross-sectional, one cohort; n > 2,000 patients). Carbetocin showed greater efficacy than oxytocin, reducing the need for additional uterotonics (5.9% vs. 15.2%) and presenting fewer adverse effects (hypotension: 30% with oxytocin vs. minimal cases with carbetocin). Its prolonged action was key in elective cesarean sections and high-risk patients. Conclusion: Carbetocin outperformed oxytocin in efficacy and safety, making it ideal for elective cesarean sections and high-risk patients.