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General gynaecology: Effect of uterotonics on intra‐operative blood loss during laparoscopy‐assisted vaginal hysterectomy: a randomised controlled trial
Author(s) -
Chang FungWei,
Yu MuHsien,
Ku ChihHung,
Chen ChiHuang,
Wu GwoJang,
Liu JahYao
Publication year - 2006
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2005.00804.x
Subject(s) - misoprostol , medicine , placebo , oxytocin , laparoscopy , hysterectomy , blood loss , randomized controlled trial , gynecology , obstetrics , pregnancy , surgery , abortion , genetics , alternative medicine , pathology , biology
Objective To investigate the effectiveness of uterotonics misoprostol and oxytocin on reducing blood loss during laparoscopy‐assisted vaginal hysterectomy (LAVH). Design Randomised, double‐blind placebo‐controlled trial. Setting University hospital. Population One hundred and seventy‐three women underwent LAVH for symptomatic uterine myomas and were randomly allocated to uterotonics ( n = 91) or placebo ( n = 82). Methods Women underwent LAVH for symptomatic uterine myomas and were randomly assigned to receive either rectal misoprostol (400 μ g) and intravenous oxytocin (10 IU/hour) or placebo during LAVH. Parameters related to surgical outcome were compared. Main outcome measures The main outcome measure was intra‐operative blood loss. Results Patient characteristics and indications for LAVH were similar in both groups. Mean [SD] for all continuous data estimated weight of blood loss (198.1 [123.2] vs 396 [337.6] g; P < 0.0001), mean operation time (106.2 [39.4] vs 116.6 [34.6] minutes; P = 0.02), mean change in haemoglobin (1.5 [1.0] vs 1.9 [1.2] g/dL; P = 0.02) and haematocrit levels (4.8 [2.9]% vs 5.8 [3.6]%; P = 0.04) and mean hospitalisation period (3.3 [0.8] vs 3.9 [1.1] days; P < 0.0001), which were significantly less in the group given rectal misoprostol and intravenous oxytocin than in the placebo group, respectively. There was no significant difference in complications and side effects between the two groups ( P > 0.05). Conclusion Combined rectal misoprostol and intravenous oxytocin is a feasible and effective method of reducing blood loss and operation time in LAVH.