A pilot study of pre-operative misoprostol in reducing operative blood loss during hysterectomy

Rectal misoprostol for myomectomy: A randomised placebo‐controlled study

“…They found no significant difference in blood loss between the two groups. A similar conclusion was obtained by Chai et al . who tested the effect of using sublingual 400 μg misoprostol taken 30 min pre‐operatively in 32 women undergoing total abdominal hysterectomy (TAH) versus 32 women receiving placebo with no observed difference in intra‐operative blood loss.…”

A Comparative Study Between Preoperative Use of Misoprostol and Dinoprostone for Reduction of Hemorrhage During Abdominal Myomectomy.

“…They found no significant difference in blood loss between the two groups. A similar conclusion was obtained by Chaiet et al (20) who tested the effect of using sublingual 400 μg misoprostol taken 30 min pre-operatively in 32 women undergoing total abdominal hysterectomy (TAH) versus 32 women receiving placebo with no observed difference in intra-operative blood loss. However, Biswas et al (21) showed that single dose of sublingual 400 μg misoprostol 30 min before (TAH) resulted in a significant reduction of intra-operative blood loss.…”

Effect of a single preoperative dose of sublingual misoprostol on intraoperative blood loss during total abdominal hysterectomy

“…By contrast, a similarly designed pilot study among 64 women undergoing TAH by Chai et al [15] failed to show any significant reduction of intraoperative blood loss during TAH (570 mL vs 521 mL; P = 0.904). These opposing findings of Chai et al [15] may be due to the following factors: recruitment of women with larger myoma (17 weeks and 16 weeks in their respective control and placebo groups vs 14 weeks and 15 weeks, respectively, in the present study); use of a more accurate (alkaline hematin) method for blood loss assessment; non‐exclusion of women with major adhesions; and a smaller sample size.…”

“…Effective myometrial contractions along with increased uterine artery resistance induced by misoprostol may help to reduce blood supply to the diseased uterus and thus may be an effective alternative to preoperative GnRH or intraoperative vasopressin in reducing blood loss during TAH. Except for a pilot study by Chai et al [15], misoprostol is yet to be evaluated for reduction of intraoperative blood loss in TAH.…”

“…Among non‐pregnant women, misoprostol has been used for cervical priming before trans‐cervical procedures [11], and for reducing blood loss in myomectomy [12,13] and laparoscopy‐assisted vaginal hysterectomy [14] with promising results. To our knowledge, only 1 pilot study has evaluated the effects of preoperative misoprostol on blood loss during TAH [15].…”