الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
A Randomized Controlled Pilot Trial The current prospective randomized controlled pilot trial was conducted at Mansoura University Obstetrics and Gynecology Department to evaluate the effect of carbetocin on reducing blood loss during hysteroscopic myomectomy. The included 40 patients were randomly assigned to two groups; group A included 20 patients who received intramyometrial carbetocin, and group B included the remaining 20 patients who received placebo. All patients received the standard preoperative assessment including proper history taking, gynecological examination, and routine preoperative laboratory investigations (especially hemoglobin level and hematocrit value). In addition, all patients were assessed by TVS to assess the number, site and size of myoma. Our primary outcome was the surgeon rating of intraoperative bleeding, while secondary outcomes included operative time, hemoglobin and hematocrit changes, fluid deficit, surgeon rating of operative field quality, and occurrence of complications. The mean age of the included cases was 36.75 and 38 years in Groups A and B respectively, with no significant difference between the two groups, No significant difference was detected between the two groups regarding their parity.Abnormal uterine bleeding was reported by 75% and 65% of patients in Groups A and B respectively, whereas the remaining cases were complaining of infertility, Most of the included myoma was type I (70% in both groups), while the remaining cases had type 0 lesions. Regarding intraoperative bleeding, it was minimal in 85% and 55% in the same two groups respectively, whereas the remaining cases had moderate bleeding. Moderate bleeding was more encountered in the placebo group. Preoperative hemoglobin values were statistically comparable between the two study groups. Nonetheless, the placebo group expressed a significant decrease in its hemoglobin level compared to the carbetocin one, Although preoperative hematocrit values showed no significant difference between the study groups, post-operative levels showed a significant increase in association with carbetocin administration. Finally, visual field showed a significant improvement in group A, and surgeon satisfaction was significantly improved in the same group. No reported intraoperative complications in our cases. Conclusion Based on the results of our study, it could be included that intravenous administration of carbetocin has a significant positive impact on the perioperative outcomes of the hysteroscopic myomectomy procedure. It is associated with shorter operative time, better operative field quality, less blood loss, minor hemoglobin changes, and better surgeon satisfaction. Its application is strongly recommended in such a setting.