Effect of Pre-Operative Single Dose of Misoprostol in Patient with Abdominal Myomectomy at Baghdad Teaching Hospital

Background: The most prevalent benign tumours in women, uterine leiomyomas, depend on estrogen for growth and development during the reproductive years. Myomectomy is a surgical treatment for leiomyomas and preserves the fertility of women. One of the most common side effects of myomectomy is bleeding, which, if not treated, could negatively affect women's health.

Aim: To determine the effect of a single dose (400 µg) of misoprostol tablet administered vaginally or rectally two hours before myomectomy on blood loss intraoperatively.

Methods: This prospective randomized study was conducted at Baghdad Teaching Hospital, Medical City, Baghdad, Iraq, from the fifth of December 2022 to the fifth of December 2023. A sample of fifty women was enrolled and divided into two groups, including the Misoprostol group (which involved twenty-five women, administrated (400 µg) of misoprostol vaginally or rectally two hours pre-operatively). The non-misoprostol group (which involved twenty -five women who underwent operation without misoprostol). The outcome factors were the operative time, hemoglobin level, and intraoperative blood loss (milliliters).

Results: It was clear from the results of this study that the misoprostol group showed decreased estimated blood loss (157.48±58.27ml) than the non-misoprostol group (511.60± 46.90ml) and higher statistical significance with a p-value of less than 0.000. Misoprostol reduced blood loss by (354ml) in the study group. A significant reduction was found in hemoglobin drop post-operatively. The results were analyzed using SPSS v.26.

Conclusion: pre-operative use of a single dose of misoprostol (400µg) vaginally or rectally is an effective method to reduce blood loss intraoperatively, and it's associated with a significant reduction in hemoglobin drop post-operatively during myomectomy.