Objectives

1. To investigate time in theatre recovery for women who received carbetocin at Caesarean Section (CS) compared with a historical cohort.

2. To compare costs per patient, from a health sector perspective, between the two cohorts.

Methods We evaluated outcomes for all women (elective and emergency) undergoing CS, after the introduction of carbetocin in April 2012. The controls comprised every 3rd patient undergoing CS in January 2012 (pre-carbetocin).

Main outcome measure Difference in time in theatre recovery between the two groups.

Results Women who received carbetocin (n = 265) spent less time in recovery than the historical cohort (n = 33) (carbetocin 170 min, syntocinon 271 min; difference: –101.3023 minutes, 95% CI: –175.8518; –26.75276, p < 0.01).

Additionally there was reduced need for additional 3^rd stage uterotonics (carbetocin 16%, syntocinon 60%; mean difference in proportion: –0.294, 95% CI: –0.1183; –0.4697). This is consistent with findings from RCTs.

Using financial modelling (Abstract No: PL.19) drug cost per patient when all 3^rd stage requirements are included is carbetocin £7.78 v syntocinon £6.37. In addition, reduced theatre recovery time has potential midwifery staffing cost efficiencies of up to £189,000 pa.

Conclusion Carbetocin decreases time spent in recovery post-CS, and reduces the need for additional 3rd stage management.

Discussion Introducing carbetocin routinely for all CS will reduce recovery times and potentially constitutes a cost saving. There are likely to be additional important staffing and theatre efficiencies.