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Syntometrine + carbetocin refers to the comparative or combined use of two uterotonic regimens for the prevention of postpartum haemorrhage (PPH). Syntometrine is a fixed-dose combination of ergometrine maleate (an ergot alkaloid) and oxytocin (a peptide hormone), designed to provide both rapid and sustained uterine contractions. Carbetocin is a synthetic, long-acting analogue of oxytocin that shares its mechanism of action but possesses a significantly longer half-life, potentially reducing the need for additional uterotonic interventions. The National University Hospital in Singapore conducted a Phase 4 randomized, double-blind trial (NCT00411619) to compare the efficacy and safety profiles of these two treatments in women undergoing vaginal delivery. Both agents primarily target the oxytocin receptor to stimulate myometrial contractions, while the ergometrine component of Syntometrine also interacts with adrenergic, serotonergic, and dopaminergic receptors to maintain uterine tone.
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