الفهرس 
? Uterine FibroidsOnly 14 pages are availabe for public view
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Abstract
: Uterine fibroids are hormone-sensitive tumors in smooth muscles. There are associated symptoms; dysmenorrhea and menstrual bleeding leading to anemia, lower abdominal pain and pressure on neighboring organs. Submucosal and intramural fibroids, which distort the endometrial cavity are considered to impair fertility.
Aim of the work: The aim of the study is to compare between the efficacy of intraoperative oxytocin infusion and preoperative vaginal misoprostol in reducing blood loss during trans- abdominal myomectomy.
Methods: After ethical committee approval and written consents from the patients, this randomized controlled trial was performed on total 100 women who were diagnosed with symptomatic fibroids and underwent trans-abdominal myomectomy under general anesthesia and willing to participate in the study at Ain Shams University Maternity hospital from July 2017 till May 2021 with inclusion and exclusion criteria.
Results: During this study, 190 patients were assessed for eligibility and 180 patients were included in the study. Of all eligible patients, 10 patients were lost to follow up and excluded from the study. Operation duration was significantly shorter among misoprostol group. Blood loss was significantly fewer among misoprostol group. No significant differences between the studied groups regarding preoperative and postoperative hemoglobin. Hemoglobin reduction was significantly lower among misoprostol group. No significant differences between the studied groups regarding preoperative and postoperative hematocrit. Hematocrit reduction was significantly lower among misoprostol group. Headache, nausea and vomiting were non-significantly less frequent among misoprostol group, while diarrhea and fever were non-significantly more frequent among misoprostol group. Postoperative hospital stay was non-significantly shorter among misoprostol group.
Conclusion: As evident from the current study, pre-operative misoprostol in abdominal myomectomy is a novel promising method for myomectomy that offers some practical advantages, such as reducing intra-operative blood loss, shorter operative time, less morbidity, blood transfusion and postoperative complications.
The present study can burden the knowledge and shed some light on future prospective studies with larger sample sizes demonstrating the long-term outcomes of pre-operative vaginal misoprostol.