title: A trial comparing the use of rectal misoprostol plus perivascular vasopressin with perivascular vasopressin alone to decrease myometrial bleeding at the time of abdominal myomectomy.
abstract: OBJECTIVE
  To compare the efficacy of rectal misoprostol plus perivascular vasopressin with perivascular vasopressin alone as hemostatic agents for the reduction of blood loss during myomectomies.
  
  
  METHODS
  Prospective, randomized, double-blind, controlled study.
  
  
  METHODS
  University of the West Indies and Andrews Memorial Hospital.
  
  
  METHODS
  Fifty women with symptomatic uterine fibroids, 25 receiving misoprostol and vasopressin and 25 receiving vasopressin alone before myomectomy.
  
  
  METHODS
  Abdominal myomectomies on patients with symptomatic uterine fibroids.
  
  
  METHODS
  Perioperative blood loss and febrile morbidity.
  
  
  RESULTS
  There were no statistically significant differences in sociodemographic, clinical, or myoma characteristics between the two groups at baseline. Postoperatively, there were no statistically significant differences in perioperative febrile morbidity or blood pressure between the groups. However, the group treated with misoprostol plus vasopressin had statistically significantly lower blood loss (geometric mean with 95% confidence interval, 334 mL [261 to 428] vs. 623 mL [354 to 1,094], a smaller change in hemoglobin (1.6 ± 1.5 vs. 3.0 ± 2.0), and a lower requirement for transfusion. In addition to treatment, significant determinants of blood loss were larger size of fibroids and greater number of fibroids.
  
  
  CONCLUSIONS
  We conclude that perivascular vasopressin plus misoprostol caused a significant reduction in blood loss compared with perivascular vasopressin alone.
  
  
  BACKGROUND
  NCT01700478.
authors.affiliation: Hugh Wynter Fertility Management Unit, University of the West Indies, Mona, Kingston, Jamaica; Department of Obstetrics and Gynaecology, University of the West Indies, Mona, Kingston, Jamaica. Electronic address: frederick.sharifa@gmail.com.
authors.forename: Sharifa
authors.initials: S
authors.lastname: Frederick
authors.forename: Joseph
authors.initials: J
authors.lastname: Frederick
authors.forename: Horace
authors.initials: H
authors.lastname: Fletcher
authors.forename: Marvin
authors.initials: M
authors.lastname: Reid
authors.forename: Milton
authors.initials: M
authors.lastname: Hardie
authors.forename: Wendy
authors.initials: W
authors.lastname: Gardner
mesh_terms: D000285:Administration, Rectal; D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006489:Hemostatic Techniques; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D007563:Jamaica; D007889:Leiomyoma / Q000601:surgery*; D016595:Misoprostol / Q000008:administration & dosage*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D063186:Uterine Myomectomy / Q000009:adverse effects*; D014594:Uterine Neoplasms / Q000601:surgery*; D014667:Vasopressins / Q000008:administration & dosage*
chemical_list: D006490:Hemostatics; D016595:Misoprostol; D014667:Vasopressins
keywords: Blood loss; febrile morbidity; misoprostol; myomectomy; vasopressin