Rectal misoprostol for myomectomy: A randomised placebo-controlled study
Article first published online: 14 JUL 2015
DOI: 10.1111/ajo.12359
Background
Uterine leiomyomas are the most common benign tumours in women.
Misoprostol, which is widely used in the treatment and prevention of
postpartum haemorrhage in obstetrics, may decrease intra-operative
bleeding in abdominal myomectomies when haemorrhage constitutes a
challenging problem.
Aims
To
assess the effect on intra-operative blood loss of using a single
pre-operative dose of rectal misoprostol in abdominal myomectomy
surgeries.
Materials and Methods
In
a randomised double-blind placebo-controlled trial, 50 women undergoing
abdominal myomectomy for symptomatic uterine leiomyomas were randomly
assigned to receive a single dose of pre-operative of rectal 400 μg
misoprostol (n = 25) or placebo (n = 25) 1 h before
the operation. The primary outcome was intra-operative blood loss. This
clinical trial was registered in clinicaltrial.gov registry with number:
NCT02061657.
Results
Intra-operative
blood loss was significantly lower in those women randomised to receive
rectal misoprostol versus the placebo group (574 ± 194.8 mL vs
874 ± 171.5 mL). Additionally, the drop in postoperative haemoglobin was
significantly less in the misoprostol group (1.7 ± 0.4 g/dL) compared
with the placebo group (2.1 ± 0.5 g/dL).
Conclusion
A
single pre-operative dose of rectal misoprostol (400 μg) is a simple
applicable method for reducing intra-operative blood loss and operative
time in abdominal myomectomy.
