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Abstract
BACK GROUND:
Fibroids are the most common benign tumors of the uterus among women. Many factors have been suggested to play a role in the etiology of these tumors or to affect their rate of growth. The most apparent factor of these, seem to be estrogen.
Uterine leiomyomas are among the most common problems encountered by the obstetrician/gynecologist. Uterine leiomyomas are the most frequent indication for hysterectomy in most of the counteries. Many patients develop myomas but still desire to retain the option of future childbearing or simply want to preserve their uterus. For these women, myomectomy, the removal of the myomas with reconstruction and preservation of the uterus, is an important option.
OBJECTIVES:
The aim of this study was to investigate the effectiveness of a single dose of preoperative rectal misoprostol in reducing intraoperative haemorrhage during conventional abdominal myomectomy.
METHODS:
This study was performed postmenstrually on 30 patients diagnosed as fibroid uterus and indicated to perform myomectomy. The age of the patients range from 25 to 40 years, all were fit and consenting for surgery and not suffering from any other gynecological pathology, where the main complaints are bleeding, dysmenorrhea and pelvic pain.
RESULTS:
Regarding our results, there was no significant difference between 2 groups in sociodemographic data, indication, uterine size, and numbers of myoma and tumor mass. Preoperative, intraoperative, and postoperative blood pressure and pulse values did not reveal any statistically significant differences for the group-to-group comparisons. The mean of uterine blood loss (ml) in group I (misoprostol group) was 172.99, while the mean of uterine blood loss (ml) in group II (control group) was 368.29. Showing significant difference between two groups in amount of blood loss. The values of haemoglobin (g/dl) postoperative show significant differences between two groups. The mean of haemoglobin in group I was 10.93 while in group II was 9.713. The values of hematocrit (%) postoperative show significant differences between two groups. The mean of hematocrit in group I was 33.49 while in group II was 30.07. The need for blood transfusion was one case (6.7%) in group I and 6 cases (40%) in group II. So there was a significant difference between two groups. As regard the operative time (minute), the mean in group I was 42.47 and the mean in group II was 52.47. So there was a significant difference between two groups. As regard period of hospitalization (day), the mean in group I was 1.47 and the mean in group II was 2.33. So there was a significant difference between two groups.The postoperative complications as febrile morbidity shows no significant differences between two groups. Exclusive of abdominal pain, there were no significant differences between two groups.
CONCLUSIONS
1. A single dose of preoperative rectal misoprostol is a simple, reliable method for reducing intraoperative blood loss,operative time, need for postoperative blood transfusion and hospital stay after abdominal myomectomies.
2. Also misoprostol gives better results in values of postoperative haemoglobin and hematocrit in study group.
3. Misoprostol has a potential of being an effetive, cheap, and stable drug.
4. It has predictable side effects and agood safety profile.