The effect of carbetocin compared with oxytocin to reduce placental retention rates in medical abortion: A randomised controlled trial

Retained placenta is a common complication following medical termination of pregnancy >13 weeks' or induction of labour for fetal demise, occurring in 19% of cases. The standard of care in our hospital is to administer intramuscular oxytocin 10IU with delivery of the fetus. A small randomised controlled trial compared use of intravenous carbetocin to oxytocin in this cohort and found a significant reduction in rate of placental retention, third stage blood loss and need for surgical curettage. We aim to randomise pregnant people >13 weeks' gestation who are undergoing medical termination or induction of labour for fetal demise to either intravenous carbetocin 100mcg or intramuscular oxytocin 10IU (standard of care) for third stage management. The primary outcome is reduction in incidence of placental retention. The secondary outcomes include total blood loss with delivery, duration of hospital stay, use of additional uterotonics, blood transfusion, high dependency unit admission, incidence of infection post delivery, need for further intervention for retained products of conception and cost effectiveness between the two groups.