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 327
- Downloads 0
Vaginal microbiota and human papillomavirus: a systematic review
Accumulating evidence indicates the potential correlation between the vaginal microbioma and the acquisition and persistence of human papillomavirus (HPV) infection. This study aims to demonstrate the potential relations...
Essure® removal in 10 steps
Many women request Essure® removal because of possible side effects related to the device itself. Laparoscopic Essure® removal in symptomatic women may be associated with improvement in quality of life. We aim to describ...
Oral care in pregnancy
Pregnant women are susceptible to a wide range of oral health conditions that could be harmful to their own health and the future of their baby. There are many myths about the safety of dental care during pregnancy. As a...
LESS hysterectomy through a bluntly created 11 mm incision
In the field of minimally invasive surgery, there is a constant drive to devise and execute the most minimally invasive surgeries possible. By the very nature of laparoscopy and robotic surgery, what one can accomplish w...
What is your diagnosis?
No summary