الفهرس 
MisoprostolOnly 14 pages are availabe for public view
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Abstract
A total abdominal hysterectomy (TAH) is one of the most common gynecological surgeries in the world. It is estimated that 45% of women under 65 years of age have experienced hysterectomies.
This surgery is performed with a variety of approaches, such as abdominal, vaginal, or laparoscopic surgery. Hemorrhage requiring a blood transfusion is one of the complications of this surgery, which occurs in 2 to 12% of cases.
Different methods have been used to reduce blood loss during a TAH. One of the most commonly used methods is a preoperative prescription (for a few months before the surgery) of gonadotropinreleasing hormones (GnRH and mifepristone) that are effective in reducing the size of the vasculature.
Misoprostol is a synthetic analog of prostaglandin E1 which not only is used to prevent and treat peptic ulcer caused by long-term use of nonsteroidal anti-inflammatory drugs, but also applies as a treatment for uterine atony. However, studies have also confirmed its crucial role in reducing postpartum hemorrhage and bleeding after undergoing surgical procedures.
Misoprostol can lead to a direct contraction of the vessels in the uterus and this feature is most likely to be useful in reducing blood loss during a TAH. In addition to the low cost of this drug, it accompanies with few side effects.
This drug is used in different doses to prepare the cervix before a dilatation, during a dilatation, a curettage or hysteroscopy. Unlike drugs, such as methionine and carboprost, misoprostol can also be prescribed to women with hypertension and asthma.
Recent pharmacological studies have shown that bioavailability of sublingual misoprostol is higher than oral, rectal, and vaginal misoprostol.
The aim of our study was to investigate the effect of a single preoperative dose of sublingual misoprostol on reducing blood loss during total abdominal hysterectomies.
This was a clinical trial study that was conducted at Department of obstetrics and gynecology at both Menoufia university hospital and Al Shohadaa Central Hospital.
Ethical Consideration:
All participants were volunteers. Verbal consent was taken from them and we explained the aim of study before the study initiation. Approval of the study protocol was obtained by Ethical Scientific Committee of Menoufia University Hospital and Al -Shohadaa central Hospital.
Inclusion Criteria:
Women who were candidate for undergoing abdominal hysterectomies at both Menoufia University Hospital and Al- Shohadaa central Hospital.
Exclusion Criteria:
Women who cannot able to take misoprostol due to different reasons such as mitral stenosis, cardiovascular diseases, glaucoma, sickle cell anemia, severe hypertension, diastolic pressure higher than 100 mm/hg, severe asthma, and known sensitivity to prostaglandins.
METHODS
The patients were randomly assigned to either the misoprostol group or the placebo one. In the misoprostol group, a 200-microgram tablet of misoprostol was taken sublingually an hour before the surgery, meanwhile a vitamin B6 tablet was taken sublingually an hour before the operation to the patients in the control group (placebo).
All of the followings were done:
Personal history: Name, age, parity and special habits. Past history: medical disorders, abdominal surgery, drug therapy and allergy. Menstrual history: menarche, regularity of the cycle and duration. Clinical examination: to exclude general and local diseases.
Number of cases:
51 women took misoprostol. 51 women took vitamin B6(the placebo drug).
The results of our present study can be summarized as follows:
This study showed that, there was no statistically significant difference between Misoprostol group and Placebo group regarding Age. There was no statistically significant difference between Misoprostol group and Placebo group regarding parity. There was no statistically significant difference between Misoprostol group and Placebo group regarding special habits.
The current study showed that, there was no statistically significant difference between Misoprostol group and Placebo group regarding BMI.