Comparing perioperative vaginal misoprostol with intraoperative pericervical hemostatic tourniquet in reducing blood loss during abdominal myomectomy: A randomized controlled trial
Journal Title: Journal of the Turkish-German Gynecological Association - Year 2019, Vol 20, Issue 1
Abstract
Objective: To compare the effectiveness of perioperative vaginal misoprostol with intraoperative pericervical hemostatic tourniquet in reducing blood loss during abdominal myomectomy. Material and Methods: A randomized controlled trial involving women with uterine leiomyoma who underwent abdominal myomectomy was conducted at a tertiary facility in Nigeria. Participants were recruited after they gave informed consent and randomized into group I (single dose 400 μg vaginal misoprostol one-hour before surgery) and group II (intraoperative pericervical hemostatic tourniquet). Eighty participants (40 in each group) were recruited. Uterine size was measured in centimeters above the pubic symphysis, and blood loss estimation involved direct volume measurement and gravimetric methods. The main outcome measures were intraoperative blood loss, blood transfusion, and recourse to hysterectomy. Ethical approval and trial registration were obtained; the data were analyzed using the SPSS software version 21.0; p<0.05 was considered significant. Results: Participants in group I had higher mean intraoperative blood loss (931.89±602.13 vs 848.40±588.85 mL, p=0.532), intra-operative blood transfusion rates (60 vs 55%; p=0.651) and mean units of blood transfused (1.30±1.20 vs 1.20±1.30; p=0.722) compared with group II. The mean uterine size (19.50±6.93 vs 20.05±6.98 cm; p=0.725) and number of fibroid nodules (11.25±7.99 vs 11.45±8.22; p=0.912) were comparable. The change in post-operative hematocrit was 2.66±2.21% vs 3.24±2.85% (p=0.315) and post-operation blood transfusion was 2.5 vs 5% (p=0.556). There was no recourse to hysterectomy in either of the study groups. While adverse effects of misoprostol occurred in 5 (12.5%) participants of group I. Conclusion: The effectiveness of perioperative vaginal misoprostol is comparable to intra-operative hemostatic pericervical tourniquet in reducing blood loss during abdominal myomectomy. (J Turk Ger Gynecol Assoc 2019; 20: 23-30)
Authors and Affiliations
Muhibat A. Afolabi, Grace G. Ezeoke, Rakiya Saidu, Munirdeen A. Ijaiya, Abiodun S. Adeniran,
Keywords
Related Articles
- EP ID EP48646
- DOI 10.4274/jtgga.galenos.2018.2018.0049
- Views 296
- Downloads 0
Clinicopathologic importance of atypical glandular cells in cervico-vaginal cytology
Objective: To analyze the histopathologic outcomes of patients with atypical glandular cells (AGC) in cervicovaginal cytology examinations. Material and Methods: Patients with AGC in cervicovaginal cytology were include...
Prevention of preterm delivery by cervical cerclage; a comparison of prophylactic and emergency procedures
Objective: Prophylactic or emergency type cervical cerclage procedures are being used for treatment of cervical insufficiency. The aim was to review and compare the outcomes of these cerclage types and identify factors a...
Management of fibroids prior to in vitro fertilization/ intracytoplasmic sperm injection: A pragmatic approach
Fibroids are relatively common in women undergoing in vitro fertilization (IVF) treatment due to their high prevalence in women. It is generally accepted that submucosal fibroids are deleterious to IVF outcomes and their...
Effect of vaginal douching on vaginal flora and genital infection
Objective: "This study aimed at examining the effect of vaginal douching (VD), which is a traditional and cultural application, on the vaginal flora and genital infections. Material and Methods: This descriptive study i...
Considerations on a new, frameless copper-releasing intrauterine system for intracesarean insertion and its future clinical significance: A review
Family planning is a system for attaining the desired number of children and enabling a desired spacing between pregnancies. Family planning can be achieved through both the use of contraceptive methods and the treatment...