Pre-Operative Rectal Misoprostol Before Myomectomy Affect Bleeding In Patients With Intramural Myoma

Background: Myomectomy is a treatment of choice in patients who intend to achieve pregnancy in future. One of the important challenges in myomectomy is intra and post-operative bleeding.Aim: To assess the efficacy of pre-operative rectal administration of misoprostol on the intra and post-operative bleeding in patients with intramural myoma.Methods: A total of 94 women who were candidate for myomectomy were randomly enrolled in this clinical trial. The intervention group received 400 mu g misoprostol rectally one hour before myomectomy. Hemoglobin and hematocrit were assessed in both intervention and control groups 4 and 24 hours after surgery. Furthermore, bleeding volume, duration of surgery, duration of admission, complications, need for transfusion and hysterectomy were assessed for both groups.Results: The findings of this study revealed that pre-operative administration of 400 mu g misoprostol resulted in a significant reduction in bleeding (p<0.001) but did not affect duration of surgery and admission, as well as complications, transfusion requirement, hysterectomy or hemoglobin and hematocrit levels 4 and 24 hours after surgery (p>0.05).Conclusions: pre-operative rectal administration of 400 mu g misoprostol resulted in reduction in intra-operative bleeding in patients with intramural myoma.