الفهرس 
CARBETOCINOnly 14 pages are availabe for public view
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Abstract
U
terine fibroids are the most common female pelvic tumors occurring in about 15% to 30% of women in the reproductive age.
When fibroids are associated with symptoms such as menorrhagia, congestive dysmenorrhoea, urinary frequency, infertility, and recurrent pregnancy losses, surgical intervention is often indicated.
Treatments include watchful waiting, medical/surgical interventions, or uterine artery embolization techniques. Therefore, in most patients with asymptomatic myoma, only care and conservative treatment are considered.
Surgeries such as myomectomy can lead to significant blood loss during the operation, and surgical hemostasis in the patient ensures success.
A number of safe and effective interventions to reduce bleeding during myomectomy have been proposed, including intramyometrial vasopressin, intramyometrial bupivacaine plus epinephrine, misoprostol, removal of myoma with unencrypted and close bilateral uterine and ovarian arteries.
Misoprostol acts through one of the 2 mechanisms to reduce blood loss. First, like prostaglandins, these prostaglandin analogs increase myometrial contractions, the second mechanism may be the direct vasoconstrictive impact of misoprostol on uterine arteries.
Carbetocin is a long-acting synthetic oxytocin analogue, a single dose of carbetocin has been hypothysed to act as a 16 hours intravenous oxytocin infusion regarding the increase in uterine tone and the reduction of the risk of PPH in elective caesarean section.
The present study is a randomized controlled study carried out in Ain Shams University Maternity Hospitals. The study included 44 women with age ranged from 25 to 40years old, subjects were distributed randomly into two equal groups: group (1) includes 22 Patients will receive 400 ug misoprostol vaginally, one hour preoperative.
group (2) includes 22 Patients will receive bolus of 100 ug Carbetocin slowly intravenously once starting anesthesia.
The aim of the study is to evaluate the efficacy of administration of carbetocin in comparison to vaginal misoprostol in decreasing blood loss in women undergoing abdominal myomectomy.
Laboratory investigations in this study revealed that there was no statistical significant difference between study groups as regards age, BMI and Parity, Preoperative hemoglobin and HCT (P >0.05).
As regards postoperative investigations of Hb and HCT highly statistical significant difference between study groups was found between both groups (P<0.001).
In comparing study groups there were no significant differences between women of both groups regarding estimated blood loss, postoperative Hb, postoperative HCT, calculated estimated blood loss, need for blood transfusion and hospital stay (P >0.05).