Effect of Oxytocin versus Misoprostol on Blood loss during Abdominal Myomectomy: a Randomised Controlled Trial

Abstract

yomectomy is the best option for women who have not completed child bearing or otherwise wish to retain their uterus. Many techniques used to reduce blood loss during myomectomy including preoperative correction of anemia, preoperative GnRH agonists, intraoperative tourniquets and clamps, intra-myometrial vasopressin and other vasoconstrictors and uterotonics (Misoprostol, Oxytocin, etc). Misoprostol is a synthetic form of prostaglandin E1 analogue which acts to reduce blood loss by increasing myometrium contractions together with the direct vasoconstrictive impact on uterine arteries. Oxytocin is a peptide hormone secreted mainly from the pituitary gland which acts to reduce blood loss through oxytocin receptors in the myometrium and fibroid tissue, which stimulates synthesis and release of contractile prostaglandins. Increased uterine contractility directly affects uterine vascular structures, decreasing blood supply to the arteries and fibroids. Decreased blood volume in the uterus and constricted uterine vasculature due to uterine contraction and vaso-constrictive effect of oxytocin results in reducing intraoperative blood loss.