الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Myomectomy is the best option for women who have not completed child bearing or otherwise wish to retain their uterus .
Many techniques used to reduce blood loss during myomectomy including preoperative Correction of anemia, preoperative GnRH agonists, intraoperative tourniquets and clamps, intramyometrial vasopressin and other vasoconstrictors and uterotonics (Misoprostol,Oxytocin, etc).
Misoprostol is a stable, synthetic form of prostaglandin E1 analogue which acts to reduce blood loss by increasing myometrial contractions together with the direct vasoconstrictive impact on uterine arteries.
This study is a randomized, controlled study that was conducted in
Ain Shams University Maternity Hospital during period time from
March 2013 to May 2014 to assess the effect of using single preoperative
dose of rectal misoprostol in abdominal myomectomy operations on
blood loss, duration of the operation and possible operative
complications.
The study involved fifty women undergoing myomectomy for symptomatic uterine myoma divided randomly into two groups Group A (Misoprostol group) which include 25 patients received two tablets of misoprostol (400 mcg) rectally two hours before the operation and Group B (Control group) which include 25 patients didn’t receive misoprostol before the operation.
The study showed that a single dose of misoprostol administered rectally two hours before abdominal myomectomy resulted in a significant reduction of blood loss (574±194.8 ml in misoprostol group vs 874±171.5 ml in control group) and operation time (76.8±15.8 min in misoprostol group vs 94.8 ± 22.8 min in control group) and so patients received misoprostol had higher postoperative hemoglobin (9.7±1 g/dl in misoprostol group vs 9.3±1 g/dl in control group) and hematocrit values (32.5±4.3% in misoprostol group vs 31.8±4% in control group).
Misoprostol lead to statistically insignificant reduction in need for blood transfusion when compared with control group (36% in misoprostol group vs 24% in control group).
Misoprostol lead to insignificant increase in febrile morbidity on the first postoperative when compared with control group (32% in misoprostol group vs 12% in control group).
No statistically significant differences were observed for other misoprostol side effects such as diarrhea (4% in misoprostol group vs 0% in control group), nausea (16% in misoprostol group vs 8% in control group) and chills (25% in misoprostol group vs 4% in control group).