Rectal misoprostol for myomectomy: A randomised placebo-controlled study

 

Rectal misoprostol for myomectomy: A randomised placebo-controlled study

1. Mohamed Abdel-Hafeez,
2. Ahmed Elnaggar,
3. Mohamed Ali,
4. Abdel Mgeed Ismail and
5. Mina Yacoub

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.