الفهرس 
Title : Comparing preoperative vaginal misoprostol, intraoperative Oxytocin Infusion, intravenous Carbetocin and pericervical hemostatic tourniquet in reducing blood loss during abdominal myomectomy
AbstractOnly 14 pages are availabe for public view
 |  | from | 154 |  |  |
| | | from | 154 | | |
Abstract
Background: Uterine fibroids have rich blood supply which may result
in intensive bleeding during the myomectomy procedure. Blood
transfusion can be required in up to 20% of the women during abdominal
myomectomy and may require hysterectomy in up to 2% of patient
undergoing abdominal myomectomy. A number of interventions have
been introduced to reduce blood loss during myomectomy and medical
agents are always an attractive option to arrest haemorrhage.
Objective: To compare the effectiveness of a single preoperative dose
of vaginal Misoprostol, intraoperative Oxytocin infusion, intravenous
Carbetocin and pericervical tourniquet for the reduction of blood loss at
the time of open abdominal myomectomy.
Methods: Between October 2020 and February 2022, 120 women were
recruited from the outpatient gynaecological clinic in Kasr AlAiny
Training Hospital. All patients presented with symptomatic intramural,
submucous or subserous myoma and were candidates for open abdominal
myomectomy.
Patients were randomized into one of four groups (30 in each group):
Misoprostol group (will receive two tablets of 200µg misoprostol
administered into the posterior fornix of the vagina 1 hour before the
onset of surgery), Oxytocin group (an infusion of 30 IU oxytocin in 500
ml normal saline started and continued during myomectomy), Carbetocin
group (will receive 100 μg IV Carbetocin (1ml) [Pabal, Ferring (UK)] in
5 ml saline over 1 minute just before skin incision) and Tourniquet group
(using a Foley catheter size 18, which will be firmly tied at the level of
the cervico-isthmic junction of the uterus before the uterine incision).
Standard technique of performing open abdominal myomectomy will be
used. Intraoperative blood loss (ml), postoperative blood loss in drain and
total estimated blood loss were calculated and recorded .The 4 groups
were compared regarding the need for blood transfusion, preoperative and
postoperative haemoglobin and haematocrit values (was measured on 24
hours before and 24 hours after surgery), Operation time (measured from
incision of first myoma to serosal closure of last myoma wound) and
post-operative hospital stay.