Efficacy of Sublingual Misoprostol for Intraoperative Blood Loss During Abdominal Hysterectomy for Leiomyoma

Objective: Uterine leiomyoma continue to be one of the most-common reasons for total abdominal hysterectomy. Misoprostol used before to surgery has also been tested for its ability to lessen blood loss during complete abdominal hysterectomy. Therefore, the purpose of this study was to determine if a single preoperative dosage of sublingual misoprostol reduced blood loss during abdominal hysterectomy and to assess this agent's potential adverse effects. Materials and Methods: This randomized controlled trial involved 80 symptomatic women with leiomyomas undergoing abdominal hysterectomy. After randomization, 40 patients received 400-μg misoprostol tablets sublingually while 40 patients did not. After administration of the tablets, 30 minutes later, surgery was performed. Intraoperative blood loss and postoperative hemoglobin were measured. Postoperative hemoglobin, change in hemoglobin, and hematocrit were noted and analysis were performed with Pearson's χ 2 test. An unpaired t -test and an analysis of variance were used to calculate the difference of means for quantitative variables. Results: Both groups were comparable, with no significant differences in their demographics, such as age, parity, body mass index, etc. Preoperative hemoglobin and hematocrit were comparable but significant differences occurred in the misoprostol group in intraoperative blood loss, hemoglobin drop, postoperative hemoglobin, and need for blood transfusion. Conclusions: Sublingual misoprostol is a cost-effective alternative to reduce blood loss in patients in a low-resource country with minimal side-effects and an acceptable route of administration. (J GYNECOL SURG 20XX:000)