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- Title
Oxytocin versus a combination of tranexamic acid and ethamsylate in reducing intraoperative bleeding during abdominal myomectomy: a randomized clinical trial.
- Authors
Abdou, Ahmed Mahmoud; Eldesouky, Elsayed; Farag, Elsayed; Mohammed, Attia; Abdelaziz, Doaa Fathy Mohamed; Shaaban, A.; Ellaban, Mostafa; Elhalim, Abd Elhalim Mohamed Abd; Elsror, Ahmed Gamal Abo; Marai, Alrefaai Abd Elfattah; Abdel-Hakam, Faiza; Abd-ElGawad, Mohamed; Elrashedy, Asmaa Ahmed; Abdelmonem, Hanaa; Kamel, Mohamed Abdelmonem; Afiffi, Ibtesam K.; Elsayed, Hazem Galal Abdelhameed; Abdelhamed, Sameh Abdelmoneim; Bosilah, Almandouh H.; Marie, Heba
- Abstract
Objective: Myomectomy is the preferred surgical approach to manage uterine fibroids. However, uterine fibroids are highly vascular tumors and, consequently, extremely susceptible to problems from myomectomy-related hemorrhage. Hence, we aim to compare oxytocin efficacy and safety profile versus tranexamic acid (TA) with ethamsylate for reducing bleeding during myomectomy. Methods: This randomized, double-blinded multicenter study was performed between 20th August 2020 and 20th October 2020 at El-Galaa Teaching Hospital, El Hussein University Hospital, Al-Azhar University Hospitals of Assiut, and Al-Azhar University Hospitals of Damietta. One hundred and eighty patients were enrolled and divided into three groups: group (1) received an injection of 30 IU of oxytocin in 500 ml of normal saline; group (2) received injections of 1 g of TA, 250 mg of Ethamsylate, and 110 ml of normal saline IV; and group (3) received an injection of 110 ml of normal saline IV just before surgical incision. Results: In 180 premenopausal women, oxytocin and TA with ethamsylate had no significant value in lowering intraoperative blood loss compared with the placebo for abdominal myomectomy (666.25 ± 183.03, 630.72 ± 145.83, and 646.67 ± 168.92, respectively (P = 0.506)). Non-significant trends were observed for a reduction in operation time (P = 0.760), intra/postoperative blood transfusion (P = 0.624), hospital stay (P = 0.986), postoperative fever (P = 0.659), and wound infection (P = 1). Conclusion: Oxytocin and TA with ethamsylate had no significant value in lowering intraoperative blood loss compared with the placebo for abdominal myomectomy which opens a new question about the role of the use of the hemostatic drug during myomectomy especially in centers with limited resources and had higher rates. Trial registration: The study was registered on Pan African Clinical Trials Registry with the following number: PACTR202008739887429 and was approved on 24/08/2020.
- Subjects
DAMIETTA (Egypt); MYOMECTOMY; JAMI'AT al-Azhar; CLINICAL trials; TRANEXAMIC acid; SURGICAL blood loss; OXYTOCIN; SURGICAL site
- Publication
BMC Women's Health, 2023, Vol 23, Issue 1, p1
- ISSN
1472-6874
- Publication type
Article
- DOI
10.1186/s12905-023-02549-z