Introduction: Given the inconsistencies and contradictions across previous studies regarding comparison of carbetocin and oxytocin in terms of postoperative adverse effects in high‑risk pregnant women, the present study was conducted with aim to compare carbetocin vs. oxytocin in the incidence of post-anesthesia complications among high‑risk parturients undergoing cesarean delivery.
Methods: This systematic review and meta‑analysis was performed in accordance with the PRISMA guidelines to compare the incidence of post-anesthesia adverse effects in high‑risk pregnant women undergoing cesarean section who received either carbetocin or oxytocin. Studies published in English or Persian was searched up to May 2025 in PubMed, Web of Science, Scopus, ClinicalTrials.gov, Google Scholar, and the Iranian databases of SID and IranDoc. Data were synthesized using odds ratios and mean differences, and heterogeneity was assessed using the I² statistic.
Results: Across the six included studies, a total of 1,124 participants were analyzed. The odds of nausea and/or vomiting were reduced to approximately 0.59 among patients receiving carbetocin; however, this reduction did not reach statistical significance. The odds ratio for headache was 0.53, which showed a significant reduction with high consistency. The odds ratio for abdominal pain was 0.69, which showed no significant difference. The odds ratio for fever was 0.69, which showed no significant difference with high heterogeneity. The odds ratio for hypotension was 1.57, indicating no significant difference with considerable variability across studies.
Conclusion: Carbetocin significantly reduces the incidence of headache following anesthesia compared to oxytocin, but no statistically significant differences were observed between the two drugs for other complications including nausea and vomiting, hypotension, abdominal pain, and fever.