Abstract
Purpose
To evaluate the effect of vaginal misoprostol on intraoperative bleeding during myomectomy.
Method
In this randomized clinical trial, 80 women with myomas were randomly assigned to receive 200 µg misoprostol or placebo (vitamin B6) 3 h before surgery. Blood loss during surgery, postoperative need for blood transfusion, and the hemoglobin level before surgery, and 6 and 12 h after surgery were assessed in two groups.
Results
Mean age and the mean preoperative and postoperative Hb levels were not significantly different between the two groups. Mean duration of surgery and mean estimated blood loss were significantly higher in control group. Nine (22.5 %) patients in control group needed blood transfusion while there was no need blood transfusion in misoprostol group (p = 0.001).
Conclusion
A single dose of vaginal misoprostol is effective in reducing hemorrhage during myomectomy.
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References
Cheng MH, Wang PH (2008) Uterine myoma: a condition amenable to medical therapy? Expert Opin Emerg Drugs 13:119–133
Haney AF (2000) Clinical decision making regarding leiomyomata: what we need in the next millennium. Environ Health Perspect 108(Suppl 5):835–839
Buttram VC Jr, Reiter RC (1981) Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril 36:433–445
Kongnyuy EJ, van den Broek N, Wiysonge CS (2008) A systematic review of randomized controlled trials to reduce hemorrhage during myomectomy for uterine fibroids. Int J Gynecol Obstet 100:4–9
LaMote AI, Lalwani S, Diamond MP (1993) Morbidity associated with abdominal myomectomy. Obstet Gynecol 82:897–900
Friedman AJ, Rein MS, Harrison-Atlas D, Garfield JM, Doubilet PM (1989) A randomized, placebo-controlled, double-blind study evaluating leuprolide acetate depot treatment before myomectomy. Fertil Steril 52:728–733
Fletcher H, Frederick J, Hardie M, Simeon D (1996) A randomized comparison of vasopressin and tourniquet as hemostatic agents during myomectomy. Obstet Gynecol 87:1014–1018
Delancey JO (1992) Anatomic aspects of vaginal eversion after hysterectomy. Am J Obstet Gynecol 166:1717–1724
Fletcher H, Frederick J, Hardie M, Simeon D (1996) A randomized comparison of vasopressin and tourniquet as hemostatic agents during myomectomy. Obstet Gynecol 87:1014–1018
Celik H, Sapmaz E (2003) Use of a single preoperative dose of misoprostol is efficacious for patients who undergo abdominal myomectomy. Fertil Steril 79(5):1207–1210
Tanha FD, Golgachi T, Niroomand N, Ghajarzadeh M, Nasr R (2013) Sublingual versus vaginal misoprostol for second trimester termination: a randomized clinical trial. Arch Gynecol Obstet 287(1):65–69
Tanha FD, Salimi S, Ghajarzadeh M (2013) Sublingual versus vaginal misoprostol for cervical ripening before hysteroscopy: a randomized clinical trial. Arch Gynecol Obstet 287(5):937–940
Park H, Yoon BS, Seong SJ, Kim JY, Shim JY, Park CT (2011) Can misoprostol reduce blood loss in laparoscopy-assisted vaginal hysterectomy? Aust N Z J Obstet Gynaecol 51(3):248–251
Chang FW, Yu MH, Ku CH, Chen CH, Wu GJ, Liu JY (2006) Effect of uterotonics on intra-operative blood loss during laparoscopy-assisted vaginal hysterectomy: a randomised controlled trial. BJOG 113(1):47–52
Tulandi T, Beique F, Kimia M (1996) Pulmonary edema: a complication of local injection of vasopressin at laparoscopy. Fertil Steril 66:478–480
Martin JD, Shenk LG (1994) Intraoperative myocardial infarction after paracervical vasopressin infiltration. Anesth Analg 79:1201–1202
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Niroomand, N., Hajiha, S., Tabrizi, N.M. et al. A single dose of misoprostol for reducing hemorrhage during myomectomy: a randomized clinical trial. Arch Gynecol Obstet 292, 155–158 (2015). https://doi.org/10.1007/s00404-015-3617-1
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DOI: https://doi.org/10.1007/s00404-015-3617-1