The Efficacy of Vasopressin Versus Misoprostol for Reducing Blood Loss During Myomectomy Operation

Document Type : Original Article

Authors

Department of Obstetrics and Gynecology*1, Faculty of Medicine, Mansoura University, Egypt

Abstract

Background: Uterine fibroid is considered the common-est non-cancerous uterine tumour. Myomectomy is a uter-ine-sparing approach that includes fibroids removal with-out uterine affection. It has been demonstrated that the estimated blood loss (EBL) during myomectomy ranges between 200 and 400 ml. Intramyometrial vasopressin injections during myomectomy might efficiently reduce the blood loss intraoperatively. Misoprostol might reduce intraoperative haemorrhage in myomectomy when haem-orrhage represents an essential challenge.   
Aim: Assessment of the efficiency of vasopressin versus misoprostol for reducing blood loss during myomectomy operation.   
Methods: This single blinded randomized controlled trial (RCT) was conducted on 2 groups, group (1) enrolled 60 patients administrate 400 ug of presurgical rectal miso-prostol 30 minutes before surgery and group (2) enrolled 60 patients administrate one ampule of vasopressin (20 units) by perivascular injection nearby vessels in the broad ligament prior to the myomectomy operation.  
Results: Our current work showed that there was no sig-nificant relationship between number of fibroids and intra-operative blood loss, also no significant relation between maximum diameter of fibroid and intraoperative blood loss. No significant difference was detected between Va-sopressin and misoprostol group regarding intraoperative blood loss and requirement for blood transfusion (BT). A significant relation was demonstrated between number of fibroid and hemoglobin (HB) level, hematocrit (HCT) level, MCV and MCH pre and post treatment in both groups and HB level, hematocrit level, MCV and MCH decrease in post than pretreatment.
Conclusion: In the context of myomectomy operation, vaginal misoprostol could be efficient as vasopressin in decreasing blood loss. A statistically significant difference of operation type was detected between different types of fibroids in both groups. Hysterectomy was more frequent in submucous group.

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