الفهرس 
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Abstract
This prospective observational comparative randomized trial was done in endoscopy unit of Obstetrics and Gynecology Department at Menoufia University hospitals. The study started in June 2013 and ended in November 2016.
This study was designed to:
1. Compare laparoscopic uterine artery ligation and vaginal misoprostol in reducing intra-operative blood loss during laparoscopic myomectomy.
2. Clearly verify the effect of uterine artery ligation by different methods upon intra- and post-operative complications of laparoscopic myomectomy procedure.
This study had included 50 women with symptomatic fibroids managed with laparoscopic myomectomy they were randomized into 2 groups. Randomization was done via reshuffled approach with the shuffled cards in ratio of 3:2 (uterine artery ligation: insertion of misoprostol) respectively.
group (1): Uterine artery ligation group:
30 women in whom uterine artery ligation was done by either: bilateral uterine artery ligation by clips or tourniquet technique.
group (2): Misoprostol group
This group included 20 patients in whom 400 g misoprostol were inserted vaginally night before surgery.
This study showed that both uterine artery ligation and pre operative misoprostol reduce blood loss during myomectomy but bilateral ligation of uterine artery has a more powerful effect than
preoperative single dose of misoprostol in reducing blood loss during laparoscopic myomectomy but bilateral ligation of uterine artery takes a longer time however no significant difference between them as regard post-operative complications. So at the end we concluded that bilateral ligation of uterine artery has a more powerful effect than preoperative single dose of misoprostol in reducing blood loss during laparoscopic myomectomy, however it takes longer time.