Reducing Blood Loss during Open Myomectomy with Intra-Myometrial Injection of Vasopressin versus Octreotide Acetate: A Double Blinded Randomized Controlled Trial

Abstract

terine leiomyomas (also referred to as fibroids or myomas) are the most common pelvic tumor in women. They arise in reproductive-age women and, when symptomatic, typically present with symptoms of abnormal uterine bleeding and/or pelvic pain/pressure. Uterine fibroids may also have reproductive effects (e.g., infertility, adverse pregnancy outcomes). Treatments include watchful waiting, medical/surgical interventions or interventional radiology (Uterine artery embolization, Magnetic resonance guided focused ultrasound or High-intensity focused ultrasound (HIFU)). Surgeries such as myomectomy may involve significant blood loss. The average volume of blood loss during abdominal myomectomy is 200 to 800 ml. Surgical hemorrhage may result in anemia, hypovolemia, and coagulation abnormalities. Various pharmacological and non-pharmacological methods have been tested to control haemorrhage during myomectomy including misoprostol, Intramyometrial vasopressin, Intramyometrial bupivacaine plus epinephrine, tranexamic acid, gelatin-thrombin matrix, ascorbic acid, dinoprostone, loop ligation, fibrin sealant patches, peri-cervical tourniquet, or tourniquet tied around both cervix and infundibulopelvic ligaments.