Comparison Of Two Different Modalities To Reduce Blood Loss During Myomectomy: A Randomized Controlled Trial.

AHMED ABDELHAKEEM, AHMED KOTB; Fakhrey, Abdelbaset; Ramadan, Ragaa Hagag; Abdelwahab, Abdelrhman Hegazy

doi:10.21608/mjmr.2023.221050.1451

Comparison Of Two Different Modalities To Reduce Blood Loss During Myomectomy: A Randomized Controlled Trial.

Document Type : Original Article

Authors

¹ Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt

² Obs gynecology department faculty of medicine Elminia university

³ obstetrics and gynecology department, faculty of medicine minia university, Minia, Egypt

⁴ Obstetrics and gynecology department minia university

10.21608/mjmr.2023.221050.1451

Abstract

Background: Uterine leiomyomas are the most common benign uterine tumors. Abdominal myomectomy is a common kind of treatment for large, symptomatic uterine fibroids in women who want to preserve their fertility. Severe intraoperative bleeding frequently poses a challenge during transabdominal myomectomy. Aim: this study aimed to compare the effectiveness of preoperative vaginal misoprostol with intraoperative pericervical tourniquet in reducing blood loss during abdominal myomectomy. Patients and Procedures:120 patients with symptomatic uterine leiomyomas who underwent abdominal myomectomy participated in this clinical randomized controlled experiment. Patients were randomly assigned to one of three equal groups. Group II received an intraoperative pericervical hemostatic tourniquet, Group III functioned as the control group and underwent surgery without any further intervention, while Group I received preoperative vaginal misoprostol 400 mcg two hours before the procedure. This study was conducted by the Obstetrics & Gynecology Department at the Minia University Maternity Hospital (MUMH). Results: When Misoprostol, Tourniquet, and Control groups were compared, it was reported that there was a statistically significant reduction in the need for blood transfusions (12.5%, 7.5%, and 30%, respectively), estimated blood loss (462.08 ± 15.43, 375.1 ± 13.98, and 661.82 ± 12.85 ml, respectively), and surgery time (64.77 ± 3.78 minutes, 55.17± 5.48, and 66.75± 6.47 minutes, respectively).conclusion: After abdominal myomectomy , preoperative vaginal misoprostol and intraoperative pericervical hemostatic tourniquet is more effective in reducing blood loss than the non-intervention approach. Preoperative vaginal misoprostol 400mcg is an effective and safe method for reducing blood loss during transabdominal myomectomy.

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