Skip to main content
Top
Published in: Archives of Gynecology and Obstetrics 1/2015

01-07-2015 | General Gynecology

A single dose of misoprostol for reducing hemorrhage during myomectomy: a randomized clinical trial

Authors: Nasrin Niroomand, Shima Hajiha, Nasrin Moghadami Tabrizi, Mahsa Ghajarzadeh

Published in: Archives of Gynecology and Obstetrics | Issue 1/2015

Login to get access

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.
Literature
1.
go back to reference Cheng MH, Wang PH (2008) Uterine myoma: a condition amenable to medical therapy? Expert Opin Emerg Drugs 13:119–133CrossRefPubMed Cheng MH, Wang PH (2008) Uterine myoma: a condition amenable to medical therapy? Expert Opin Emerg Drugs 13:119–133CrossRefPubMed
2.
go back to reference Haney AF (2000) Clinical decision making regarding leiomyomata: what we need in the next millennium. Environ Health Perspect 108(Suppl 5):835–839CrossRefPubMed Haney AF (2000) Clinical decision making regarding leiomyomata: what we need in the next millennium. Environ Health Perspect 108(Suppl 5):835–839CrossRefPubMed
3.
go back to reference Buttram VC Jr, Reiter RC (1981) Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril 36:433–445PubMed Buttram VC Jr, Reiter RC (1981) Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril 36:433–445PubMed
4.
go back to reference 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 100:4–9CrossRef 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 100:4–9CrossRef
5.
go back to reference LaMote AI, Lalwani S, Diamond MP (1993) Morbidity associated with abdominal myomectomy. Obstet Gynecol 82:897–900 LaMote AI, Lalwani S, Diamond MP (1993) Morbidity associated with abdominal myomectomy. Obstet Gynecol 82:897–900
6.
go back to reference 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 52:728–733PubMed 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 52:728–733PubMed
7.
go back to reference Fletcher H, Frederick J, Hardie M, Simeon D (1996) A randomized comparison of vasopressin and tourniquet as hemostatic agents during myomectomy. Obstet Gynecol 87:1014–1018CrossRefPubMed Fletcher H, Frederick J, Hardie M, Simeon D (1996) A randomized comparison of vasopressin and tourniquet as hemostatic agents during myomectomy. Obstet Gynecol 87:1014–1018CrossRefPubMed
8.
go back to reference Delancey JO (1992) Anatomic aspects of vaginal eversion after hysterectomy. Am J Obstet Gynecol 166:1717–1724CrossRefPubMed Delancey JO (1992) Anatomic aspects of vaginal eversion after hysterectomy. Am J Obstet Gynecol 166:1717–1724CrossRefPubMed
9.
go back to reference Fletcher H, Frederick J, Hardie M, Simeon D (1996) A randomized comparison of vasopressin and tourniquet as hemostatic agents during myomectomy. Obstet Gynecol 87:1014–1018CrossRefPubMed Fletcher H, Frederick J, Hardie M, Simeon D (1996) A randomized comparison of vasopressin and tourniquet as hemostatic agents during myomectomy. Obstet Gynecol 87:1014–1018CrossRefPubMed
10.
go back to reference 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):1207–1210CrossRefPubMed 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):1207–1210CrossRefPubMed
11.
go back to reference 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):65–69CrossRefPubMed 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):65–69CrossRefPubMed
12.
go back to reference 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):937–940CrossRefPubMed 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):937–940CrossRefPubMed
13.
go back to reference 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):248–251CrossRefPubMed 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):248–251CrossRefPubMed
14.
go back to reference 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):47–52CrossRefPubMed 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):47–52CrossRefPubMed
15.
go back to reference Tulandi T, Beique F, Kimia M (1996) Pulmonary edema: a complication of local injection of vasopressin at laparoscopy. Fertil Steril 66:478–480PubMed Tulandi T, Beique F, Kimia M (1996) Pulmonary edema: a complication of local injection of vasopressin at laparoscopy. Fertil Steril 66:478–480PubMed
16.
go back to reference Martin JD, Shenk LG (1994) Intraoperative myocardial infarction after paracervical vasopressin infiltration. Anesth Analg 79:1201–1202PubMed Martin JD, Shenk LG (1994) Intraoperative myocardial infarction after paracervical vasopressin infiltration. Anesth Analg 79:1201–1202PubMed
Metadata
Title
A single dose of misoprostol for reducing hemorrhage during myomectomy: a randomized clinical trial
Authors
Nasrin Niroomand
Shima Hajiha
Nasrin Moghadami Tabrizi
Mahsa Ghajarzadeh
Publication date
01-07-2015
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 1/2015
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-015-3617-1

Other articles of this Issue 1/2015

Archives of Gynecology and Obstetrics 1/2015 Go to the issue