COMPARISON OF INTRAOPERATIVE MEAN BLOOD LOSS BETWEEN UTERINE ARTERY TOURNIQUET AND VAGINAL MISOPROSTOL IN CASES UNDERGOING TRANSABDOMINAL MYOMECTOMY

Abstract

Background: Transabdominal myomectomy is a common surgical procedure for the removal of uterine fibroids, often associated with significant intraoperative blood loss. Effective techniques to minimize blood loss are essential for improving surgical outcomes and reducing complications. Uterine artery tourniquet and vaginal misoprostol are widely used methods, but comparative data on their efficacy remain limited.

Objective: To compare the intraoperative mean blood loss, operative time, and hospital stay duration between uterine artery tourniquet and vaginal misoprostol in patients undergoing transabdominal myomectomy.

Study Design: Randomized Controlled Trial

Settings :Department of Obstetrics and Gynaecology, Bahawal Victoria Hospital, Bahawalpur.

Duration: 23-Feb-2024 to 23-Aug-2024.

Results: A total of 54 patients were included, with 27 assigned to the uterine artery tourniquet group and 27 to the vaginal misoprostol group. The mean intraoperative blood loss was 432.59 ± 191.31 ml in the uterine artery tourniquet group and 371.19 ± 204.46 ml in the vaginal misoprostol group (p = 0.260). The mean operative times were 121.93 ± 35.23 minutes and 123.81 ± 36.94 minutes (p = 0.848), respectively. The mean hospital stay durations were 2.93 ± 1.49 days and 2.85 ± 1.35 days (p = 0.849). Subgroup analyses based on parity and myoma characteristics showed no statistically significant differences between groups.

Conclusion: Both uterine artery tourniquet and vaginal misoprostol are equally effective in minimizing intraoperative blood loss, operative time, and hospital stay duration during transabdominal myomectomy. These findings support their use as viable options based on patient profiles and surgical requirements.