Effect of Sublingual Misoprostol on Intraoperative Blood Loss During Abdominal Hysterectomy: Randomized Controlled Trial
Seif Eldin Farhan Gomaa Abd Elgawad;
Abstract
Hysterectomy is the surgical removal of the uterus. It is the most frequently performed major gynaecological surgical procedure, with millions of procedures performed annually throughout the world (DeLancey et al., 2013).
Hysterectomy can be performed for benign and malignant indications. Approximately 90% of hysterectomies are performed for benign conditions, such as fibroids causing abnormal uterine bleeding; other indications include endometriosis/adenomyosis, dysmenorrhoea, dyspareunia and prolapsed (Panda et al., 2015).
Hemorrhage is a feared complication for any surgeon. Intraoperative hemorrhage occurs in 1% to 2% of hysterectomies, intraoperative hemorrhage is defined as blood loss >1L or any blood loss that requires a blood transfusion (Parker and Wagner, 2010).
Misoprostol (15-deoxy-16-hydroxy-16-methyl PGE1) is a synthetic prostaglandin E1 analogue was developed for gastric ulcer prevention but commonly used in reproductive health because of its uterotonic and cervical priming action (Laura et al., 2016).
The misoprostol tablet is very soluble and can be dissolved in 20 minutes when it is put under the tongue. Sublingual misoprostol has the shortest time to peak concentration, the highest peak concentration and the greatest bioavailability when compared to other routes (Tang et al., 2007).
This study aimed to investigate whether preoperative administration of sublingual misoprostol is beneficial in reducing intraoperative blood loss among women undergoing total abdominal hysterectomy.
This study was carried on one hundred and eighteen patients, they were randomly allocated in two groups:
- Group A: Included 59 patients undergone total abdominal hysterectomy and received 400 μg of sublingual Misoprostol 30 minutes before operation.
- Group B: Included 59 patients undergone total abdominal hysterectomy and received Placebo 30 minutes before operation.
All of them were subjected to:
- Detailed history taking.
- Abdominal and pelvic examination.
- Baseline demographic data comprising age, parity, body
Hysterectomy can be performed for benign and malignant indications. Approximately 90% of hysterectomies are performed for benign conditions, such as fibroids causing abnormal uterine bleeding; other indications include endometriosis/adenomyosis, dysmenorrhoea, dyspareunia and prolapsed (Panda et al., 2015).
Hemorrhage is a feared complication for any surgeon. Intraoperative hemorrhage occurs in 1% to 2% of hysterectomies, intraoperative hemorrhage is defined as blood loss >1L or any blood loss that requires a blood transfusion (Parker and Wagner, 2010).
Misoprostol (15-deoxy-16-hydroxy-16-methyl PGE1) is a synthetic prostaglandin E1 analogue was developed for gastric ulcer prevention but commonly used in reproductive health because of its uterotonic and cervical priming action (Laura et al., 2016).
The misoprostol tablet is very soluble and can be dissolved in 20 minutes when it is put under the tongue. Sublingual misoprostol has the shortest time to peak concentration, the highest peak concentration and the greatest bioavailability when compared to other routes (Tang et al., 2007).
This study aimed to investigate whether preoperative administration of sublingual misoprostol is beneficial in reducing intraoperative blood loss among women undergoing total abdominal hysterectomy.
This study was carried on one hundred and eighteen patients, they were randomly allocated in two groups:
- Group A: Included 59 patients undergone total abdominal hysterectomy and received 400 μg of sublingual Misoprostol 30 minutes before operation.
- Group B: Included 59 patients undergone total abdominal hysterectomy and received Placebo 30 minutes before operation.
All of them were subjected to:
- Detailed history taking.
- Abdominal and pelvic examination.
- Baseline demographic data comprising age, parity, body
Other data
| Title | Effect of Sublingual Misoprostol on Intraoperative Blood Loss During Abdominal Hysterectomy: Randomized Controlled Trial | Other Titles | تأثير جرعة الميزوبريستول تحت اللسان على فقد الدم أثناء جراحة إستئصال الرحم من خلال البطن | Authors | Seif Eldin Farhan Gomaa Abd Elgawad | Issue Date | 2017 |
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