Effect of intravaginal misoprostol use on uterine artery blood flow in patients with myoma uteri

Çelik, Hüsnü; Sapmaz, Ekrem; Serhatlioğlu, Selami; Parmaksız, Cem; Altingül, Aygen

doi:10.1016/j.fertnstert.2003.05.017

Cited by 9 publications

(7 citation statements)

References 13 publications

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“…Research in major cohorts of patients might be necessary here. According to our observations obtained from the present study, we suspect that misoprostol causes a strong and sudden constriction of blood vessels, which stands in line with previous observations (Yip et al 2000;Celik et al 2003).…”

Section: Discussionsupporting

confidence: 93%

“…According to available data, clinicians recommend the administration of misoprostol during myomectomy, as it might reduce bleeding, decrease the volume of transfusions and shorten surgery duration (Iavazzo et al 2015). According to Celik et al (2003), the use misoprostol causes a decrease in uterine artery blood flow. The authors suggested that it might be evaluated as an occlusion method and considered a treatment alternative in patients with UFs (Celik et al 2003).…”

Section: Introductionmentioning

confidence: 99%

“…According to Celik et al (2003), the use misoprostol causes a decrease in uterine artery blood flow. The authors suggested that it might be evaluated as an occlusion method and considered a treatment alternative in patients with UFs (Celik et al 2003).…”

Section: Introductionmentioning

confidence: 99%

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Oxytocin and Misoprostol With Diclofenac in the Preparation for Magnetic Resonance–Guided High-Intensity Ultrasound Treatment of Symptomatic Uterine Fibroids: A Prospective Cohort Study

Łoziński¹,

Ludwin

Filipowska

et al. 2021

Ultrasound in Medicine & Biology

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Uterine fibroids (UFs) are very common benign tumors of the female reproductive tract. According to recent reports, magnetic resonanceÀguided high-intensity ultrasound (MR-HIFU) appears to be a well-tolerated and efficient treatment option for UFs. However, MR-HIFU still presents several limitations. The treatment is rarely associated with achieving complete non-perfused volume (NPV). Not all patients are qualified for a final procedure, and selected women obtain very good results in such treatment. The primary objective of this experimental study was to assess the effect of transvaginal misoprostol and intravenous oxytocin preparation on UF volume change, sonication time and NPV after MR-HIFU procedure in women of reproductive age with symptomatic UFs. Secondary outcomes included the effect on the peri-procedural effectiveness of misoprostol and oxytocin. This study enrolled 247 women with symptomatic UFs; based on gynecologic examinations and magnetic resonance imaging (MRI) scans, 128 women qualified for MR-HIFU without pharmacologic treatment, 57 women qualified for the misoprostol/diclofenac group and 62 women qualified for the oxytocin group. Pharmacologic pre-treatment improved NPV compared with non-pharmacologic treatment (average NPV: controls 61.9% § 25.8%; oxytocin 76.8% § 20.7%; misoprostol/diclofenac 85.2% § 15.1%; average sonication time: controls 120 min § 56.4%; oxytocin 111 min § 45.4%; misoprostol/diclofenac 80 min § 47.7%). Statistical analysis did not reveal significant intergroup differences in UF volume changes after 6 mo (controls: n = 40, 37.4% § 27.5%; oxytocin n = 25, 45.8% § 31%; misoprostol/diclofenac n = 19, 33.4% § 23.2%). The misoprostol/diclofenac group, which achieved the highest NPV immediately after the MR-HIFU procedure, was characterized by the lowest UF volume change percentages 6 mo later. The administration of vasoconstrictor drugs (oxytocin and misoprostol/diclofenac) to support MR-HIFU in UF treatment is a new issue that may improve the total effectiveness of this method. Randomized controlled trials are necessary to estimate the real effect of vasoconstrictors on MR-HIFU.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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Oxytocin and Misoprostol With Diclofenac in the Preparation for Magnetic Resonance–Guided High-Intensity Ultrasound Treatment of Symptomatic Uterine Fibroids: A Prospective Cohort Study

Łoziński¹,

Ludwin

Filipowska

et al. 2021

Ultrasound in Medicine & Biology

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“…Strong myometrial contractions induced by misoprostol indirectly cause relative avascularity in the myoma and may also contribute to a reduction in bleeding, particularly among women requiring concurrent myomectomy for cervical and broad ligament myoma. In addition, a decrease in uterine artery blood flow in myoma has been observed by Doppler velocimetry after misoprostol administration [17].…”

Section: Introductionmentioning

confidence: 97%

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

Biswas¹,

Chaudhuri

Mandal

et al. 2013

Intl J Gynecology & Obste

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“…Investigators have reported that the most common side effects after administration of 400 µg of vaginal or oral misoprostol are chills (17.3%), nausea and vomiting (10.2%), headache and vertigo (7.1%), abdominal pain (79.6%), and diarrhea (4.1%) (14). In addition to these side effects, some studies have reported a slight increase or decrease in blood pressure.…”

Section: Discussionmentioning

confidence: 99%

Comparing the Outcomes and Side Effects of Administration of a Single Preoperative Dose of Vaginal Misoprostol With Intraoperative Oxytocin Infusion in Blood Loss During Abdominal Myomectomy

Mostafa-Gharabaghi¹,

Alizadeh²,

Atashkhoye³

et al. 2016

International Journal of Women’s Health and Reproduction Scienc

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Introduction Uterine fibroids are the most common female pelvic tumors occurring in about 15% to 30% of women in the reproductive age. In an epidemiologic study published in 2003 in the United States, 80% of black and nearly 70% of white women were demonstrated to have ultrasound evidence of leiomyomas (1). When fibroids are associated with symptoms such as menorrhagia, congestive dysmenorrhoea, urinary frequency, infertility, and recurrent pregnancy losses, surgical intervention is often indicated (2). To date, there have been many fertility sparing procedures which have been used to alleviate the symptoms and enhance the fertility in women with uterine fibroids. Procedures such as uterine artery embolization (3), myolysis (4), and laparoscopic myomectomy (5,6) have been used in the treatment of uterine fibroids. A number of trials have been carried out to assess the effectiveness and safety of interventions in reducing the blood loss during myomectomy (7). Such interventions include intramyometrial vasopressin (8), intravenous oxytocin (9), tourniquets (10), chemical dissection with sodium-2-mercapto ethane sulfonate (mesna) (11), and intramyometrial bupivacaine plus epinephrine (12). A study was conducted by Ragab and colleagues in 2014 in Saudi Arabia on 69 patients undergoing abdominal myomectomy. It was shown that the use of 400 µg of vaginal or oral misoprostol 60 minutes before myomectomy reduced intraoperative bleeding and operation time (13). Vasopressin has already been shown to decrease blood loss at the time of myomectomy (8,10). Misoprostol is now being used by obstetricians and gynecologists worldwide for the evacuation of the uterus for missed abortions, intrauterine deaths, induction of labor, and the prevention of postpartum hemorrhage (14,15). Its popularity especially in developing countries such as Jamaica may be accounted for the fact that it is able to produce powerful uterine contractions and lead to a reduction in myometrial hemorrhage, while being inexpensive and easy to store. Contrary to a previous study in Turkey (14), we chose to investigate the use of misoprostol in a larger subset of patients in conjunction with oxytocin in a Persian population with a high incidence of myomectomies (8). This surgical procedure (myomectomy) involves a significant risk of hemorrhage (16). Different treatments have been proposed to reduce hemorrhage during myomectomy (17). Oxytocin administration reduces blood loss after delivery and this hormone is widely used to prevent postpartum hemorrhage (9). In this study, we compared the effectiveness of a single preoperative dose of misoprostol with intraoperative oxy-Abstract Objectives: This study aimed to compare the effectiveness of a single preoperative dose of misoprostol with intraoperative oxytocin infusion in abdominal myomectomies. Materials and Methods: Patients undergoing abdominal myomectomies were divided into 2 groups. An hour before the operation, women in the misoprostol group (n = 35) received a single dose of vaginal misoprostol (400 μg); t...

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Effect of intravaginal misoprostol use on uterine artery blood flow in patients with myoma uteri

Cited by 9 publications

References 13 publications

Oxytocin and Misoprostol With Diclofenac in the Preparation for Magnetic Resonance–Guided High-Intensity Ultrasound Treatment of Symptomatic Uterine Fibroids: A Prospective Cohort Study

Oxytocin and Misoprostol With Diclofenac in the Preparation for Magnetic Resonance–Guided High-Intensity Ultrasound Treatment of Symptomatic Uterine Fibroids: A Prospective Cohort Study

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

Comparing the Outcomes and Side Effects of Administration of a Single Preoperative Dose of Vaginal Misoprostol With Intraoperative Oxytocin Infusion in Blood Loss During Abdominal Myomectomy

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