Role of Administration of Sublingual Misoprostol Before Open Myomectomy.
El-Demiry, N., Atta, F., Abdelaal, M., Abo Elkassem, M., Farouk, D. (2024). Role of Administration of Sublingual Misoprostol Before Open Myomectomy.. EKB Journal Management System, 28(5), 58-65. doi: 10.21608/egyfs.2024.388595
Nihal Mostafa El-Demiry; Fatma Magdy Atta; Mostafa Ahmed Abdelaal; Mohammed Abo Elkassem; Dalia Farouk. "Role of Administration of Sublingual Misoprostol Before Open Myomectomy.". EKB Journal Management System, 28, 5, 2024, 58-65. doi: 10.21608/egyfs.2024.388595
El-Demiry, N., Atta, F., Abdelaal, M., Abo Elkassem, M., Farouk, D. (2024). 'Role of Administration of Sublingual Misoprostol Before Open Myomectomy.', EKB Journal Management System, 28(5), pp. 58-65. doi: 10.21608/egyfs.2024.388595
El-Demiry, N., Atta, F., Abdelaal, M., Abo Elkassem, M., Farouk, D. Role of Administration of Sublingual Misoprostol Before Open Myomectomy.. EKB Journal Management System, 2024; 28(5): 58-65. doi: 10.21608/egyfs.2024.388595

Role of Administration of Sublingual Misoprostol Before Open Myomectomy.

The Egyptian Journal of Fertility and Sterility
Volume 28, Issue 5 - Serial Number 11106352, September 2024, Page 58-65  XML PDF (228.59 K)
Document Type: Original Article
DOI: 10.21608/egyfs.2024.388595
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Authors
Nihal Mostafa El-Demiry email 1; Fatma Magdy Atta2; Mostafa Ahmed Abdelaal3; Mohammed Abo Elkassem2; Dalia Farouk2
1Department of Obstetrics and Gynecology, Faculty of Medicine - Cairo University, Cairo, Egypt.
2Obstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Egypt
3Obstetrics and Gynecology Department, El Menshawy General Hospital, Egypt
Abstract
Background: Uterine fibroids are considered the most prevalent benign tumors in women. open myomectomy is the conventional management for large or numerous fibroids. However, hemorrhage is one of the most prevalent consequences in open myomectomy cases. Misoprostol, an analog of prostaglandin E1, is widely used in obstetrics and is capable of increasing uterine contraction and decreasing hemorrhage. Our aim was to assess the impact of sublingual intake of Misoprostol before myomectomy to minimize blood loss during surgery.   
Methods: A randomized controlled clinical trial was conducted on 150 women within their reproductive age with symptomatic fibroids who are planned for open myomectomy.  They were randomized into “study” and “control” groups to receive either one dose of Misoprostol sublingually (400 mcg) or placebo before myomectomy. The operative time, intraoperative blood loss and the effect of blood loss on hematocrit and hemoglobin levels were assessed.   
Results: The operative time among the Misoprostol group was significantly shorter than the placebo group ( 58.80±4.51 vs 71.08±10.62 minutes,p<0.001). Additionally, the blood loss in the suction apparatus and the total blood losses among the Misoprostol group were significantly reduced compared to the control group (279.16±44.61 vs 340.55±66.71 ml , p<0.001).
Conclusion: A sublingual dose of Misoprostol (400 mcg) one hour before surgery significantly reduces the intraoperative blood loss and the operation time during myomectomy. 
Keywords
Keywords: Myomectomy; Misoprostol; Blood loss
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