title: Rectal misoprostol for myomectomy: A randomised placebo-controlled study.
abstract: BACKGROUND
  Uterine leiomyomas are the most common benign tumours in women. Misoprostol, which is widely used in the treatment and prevention of postpartum haemorrhage in obstetrics, may decrease intra-operative bleeding in abdominal myomectomies when haemorrhage constitutes a challenging problem.
  
  
  OBJECTIVE
  To assess the effect on intra-operative blood loss of using a single pre-operative dose of rectal misoprostol in abdominal myomectomy surgeries.
  
  
  METHODS
  In a randomised double-blind placebo-controlled trial, 50 women undergoing abdominal myomectomy for symptomatic uterine leiomyomas were randomly assigned to receive a single dose of pre-operative of rectal 400 μg misoprostol (n = 25) or placebo (n = 25) 1 h before the operation. The primary outcome was intra-operative blood loss. This clinical trial was registered in clinicaltrial.gov registry with number: NCT02061657.
  
  
  RESULTS
  Intra-operative blood loss was significantly lower in those women randomised to receive rectal misoprostol versus the placebo group (574 ± 194.8 mL vs 874 ± 171.5 mL). Additionally, the drop in postoperative haemoglobin was significantly less in the misoprostol group (1.7 ± 0.4 g/dL) compared with the placebo group (2.1 ± 0.5 g/dL).
  
  
  CONCLUSIONS
  A single pre-operative dose of rectal misoprostol (400 μg) is a simple applicable method for reducing intra-operative blood loss and operative time in abdominal myomectomy.
authors.affiliation: Department of Obstetrics and Gynaecology, Ain Shams University, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdel-Hafeez
authors.affiliation: Department of Obstetrics and Gynaecology, Ain Shams University, Cairo, Egypt.|Department of Obstetrics and Gynaecology, Jersey General Hospital, Jersey, UK.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Elnaggar
authors.affiliation: Department of Obstetrics and Gynaecology, Ain Shams University, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ali
authors.affiliation: Department of Obstetrics and Gynaecology, Ain Shams University, Cairo, Egypt.
authors.forename: Abdel Mgeed
authors.initials: AM
authors.lastname: Ismail
authors.affiliation: Department of Obstetrics and Gynaecology, Ain Shams University, Cairo, Egypt.
authors.forename: Mina
authors.initials: M
authors.lastname: Yacoub
mesh_terms: D000285:Administration, Rectal; D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control* / Q000706:statistics & numerical data; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000601:surgery*; D008875:Middle Aged; D016595:Misoprostol / Q000627:therapeutic use*; D010120:Oxytocics / Q000627:therapeutic use*; D011300:Preoperative Care / Q000379:methods*; D016896:Treatment Outcome; D063186:Uterine Myomectomy; D014594:Uterine Neoplasms / Q000601:surgery*
chemical_list: D010120:Oxytocics; D016595:Misoprostol
keywords: blood loss; leiomyoma; misoprostol; myomectomy