Vaginal Misoprostol versus Carbetocin in Decreasing Blood Loss in Abdominal Myomectomy: Randomized Controlled Trial

Abstract

Uterine fibroids are the most common female pelvic tumors occurring in about 15% to 30% of women in the reproductive age. When fibroids are associated with symptoms such as menorrhagia, congestive dysmenorrhoea, urinary frequency, infertility, and recurrent pregnancy losses, surgical intervention is often indicated. Treatments include watchful waiting, medical/surgical interventions, or uterine artery embolization techniques. Therefore, in most patients with asymptomatic myoma, only care and conservative treatment are considered. Objective: The aim of the study is to evaluate the efficacy of administration of carbetocin in comparison to vaginal misoprostol in decreasing blood loss in women undergoing abdominal myomectomy. Methods: The present study is a randomized controlled study carried out in Ain Shams University Maternity Hospitals. The study included 44 women with age ranged from 25 to 40years old, subjects were distributed randomly into two equal groups: Group (1) includes 22 Patients will receive 400 ug misoprostol vaginally, one hour preoperative. Group (2) includes 22 Patients will receive bolus of 100 ug Carbetocin slowly intravenously once starting anesthesia. Results: Laboratory investigations in this study revealed that there was no statistical significant difference between study groups as regards age, BMI and Parity, Preoperative hemoglobin and HCT (P >0.05). As regards postoperative investigations of Hb and HCT highly statistical significant difference between study groups was found between both groups (P<0.001). In comparing study groups there were no significant differences between women of both groups regarding estimated blood loss, postoperative Hb, postoperative HCT, calculated estimated blood loss, need for blood transfusion and hospital stay (P >0.05). Conclusion: This study is a randomized controlled study, and was carried out in Ain Shams University Maternity Hospitals. It was carried out to determine and to compare the effects of carbetocin and vaginal misoprostol in reducing blood loss during abdominal myomectomy. Our results showed no statistical difference was found between misoprostol and cabetocin groups in estimated blood loss, calculated estimated blood loss, need for blood transfusion and hospital stay