Key result
Preoperative rectal misoprostol cuts intraoperative blood loss ~25% vs control during total abdominal hysterectomy.
Why the study?
The effectiveness of a single pre-operative rectal dose of misoprostol for reducing intraoperative blood loss in total abdominal hysterectomy for symptomatic uterine fibroids and abnormal uterine bleeding was studied.
Does a pre-operative single rectal dose of misoprostol reduce intraoperative blood loss in women undergoing total abdominal hysterectomy for uterine fibroids?
RCT (n=100)
Randomized
No
Does a pre-operative single rectal dose of misoprostol reduce intraoperative blood loss in women undergoing total abdominal hysterectomy for uterine fibroids?
Absolute Event Rate: 243.3% vs 323.5%
p-value: p=<0.05
A single pre-operative rectal dose of misoprostol significantly reduces intraoperative blood loss and postoperative anemia in women undergoing total abdominal hysterectomy for fibroids.
May reduce hysterectomy blood loss; hypothesis-generating and requires randomized confirmation before practice change.
Objective:To study the effectiveness of a pre-operative single dose rectal misoprostol for reducing blood loss of abdominal hysterectomy with or without salphingo – oophorectomy performed for uterine fibroid which are symptomatic and abnormal uterine bleeding. Methods:This study conducted on patients planned for Total Abdominal Hysterectomy in the Department of Obstetrics and Gynaecology, RMMC&H during the period of October 2018 to October 2019. After the administration of 400 micrograms of Misoprostol to the case group A (n=48), they were compared with control group B (n=52) on blood loss.Results:Amount of bleeding during the operation seems to be significantly lower in cases for whom Misoprostol was used. (Group A patients had a significantly lesser intra-operative blood loss (243.3 ± 27.3 ml) than their counterpart (323.5 ± 28.7 ml)). Our findings clearly indicates that both the Hemoglobin levels and Hematocrit values have declined at a significantly lower pace post-TAH (24hrs after surgery) in the group A than group B (p<0.05). The proportion of anemic patients has raised significantly in the group B following TAH than the increase of anemic patients found in the group A. This result further supports the beneficial role played by Misoprostol.Conclusion:A single dose of rectal Misoprostol has positive effect on reducing intraoperative blood loss in women undergoing total abdominal hysterectomy due to fibroids and abnormal uterine bleeding.
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Latha et al. (2019) conducted an RCT in Symptomatic fibroids and abnormal uterine bleeding (n=100). Misoprostol vs. Control was evaluated on Intraoperative blood loss (ml) (p=<0.05). A single 400 microgram rectal dose of misoprostol administered 30 minutes before surgery significantly reduced intraoperative blood loss compared to control (243.3 ml vs 323.5 ml) in women undergoing total abdominal hysterectomy.
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