Hematological profile and transfusion requirement during hysteroscopic myomectomy: A comparative study between oxytocin and tranexamic acid infusion

Mousa, Sherif Abdo; Yassen, Amr M.; Alhadary, Hala Salah; Sadek, Ehab; Abdel-Hady, El-Said

doi:10.1016/j.egja.2011.12.003

Cited by 16 publications

(8 citation statements)

References 20 publications

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“…Mousa and colleagues recruited 50 women scheduled for hysteroscopic myomectomy, and randomly assigned them to receive either tranexamic acid (15 mg/kg), or oxytocin (at 400 mU/min). 12 Similar to our study, they reported no significant difference between the two groups regarding operative time or the need for blood transfusion. However, they reported a significant decrease of the postoperative hemoglobin and hematocrit values in the tranexamic acid group.…”

Section: Discussionsupporting

confidence: 88%

“…In the previous reported studies, no intraoperative or postoperative complications were reported in either group. 12,13 Differently, uterine perforation was the only intraoperative complication occurred (no cases of cervical tears or fluid overload). This complication occurred in one case in each group, and was due to false passage of the cervical dilators prior to the introduction of the resectoscope.…”

Section: Discussionmentioning

confidence: 97%

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Effect of oxytocin infusion versus tranexamic acid on reducing blood loss during hysteroscopic myomectomy: a randomized controlled trial

Mohamed¹,

Helaly²,

Salama³

2019

Int J Reprod Contracept Obstet Gynecol

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Background: Women undergoing hysteroscopic myomectomy are prone to significant blood loss and hematological disturbances. Oxytocin is a uterotonic drug, used mainly in obstetric practice. Tranexamic acid is a haemostatic drug that has been used to reduce blood loss after trauma and in many surgeries. The aim of our study was to compare the safety and efficacy of oxytocin versus tranexamic acid in reducing perioperative blood loss during hysteroscopic myomectomy.Methods: This study included 60 patients scheduled for hysteroscopic myomectomy allocated into 2 groups: group A: received 10 mg/kg of tranexamic acid slowly intravenous after induction of anesthesia, while group B: received infusion of 10 IU of oxytocin at a rate of 400 mIU/min throughout the procedure. Preoperative and postoperative hemoglobin and hematocrit levels, need for blood transfusion, duration of operation, complications and medications adverse effects were recorded.Results: The 2 groups were comparable in terms of the mean difference between preoperative and postoperative hemoglobin a hematocrit levels, operative time, operative complication and medications’ adverse effects. No patients needed blood component transfusion in either group.Conclusions: It can be concluded that tranexamic acid and oxytocin are equally effective in reducing blood loss and transfusion requirements during hysteroscopic myomectomy with comparable good safety profiles. Both of them can be used according to availability and surgeon preferences.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 97%

Effect of oxytocin infusion versus tranexamic acid on reducing blood loss during hysteroscopic myomectomy: a randomized controlled trial

Mohamed¹,

Helaly²,

Salama³

2019

Int J Reprod Contracept Obstet Gynecol

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“…EACA is an antifibrinolytic analogue of lysine and prevents activation and conversion of plasminogen to plasmin on fibrin surface (19). This effect is achieved by the attachment of plasminogen to lysine C-terminal remnants on relatively degraded fibrin molecules and consequently, the location of attachment of plasminogen that is essential for the development of plasmin is occupied (20).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Intraoperative Outcomes of Intrauterine Instillation of Epsilon-Aminocaproic Acid and Intravenous Oxytocin in Hysteroscopy Surgeries

Sayyah-Melli¹,

Rogayeh²,

Parvin³

et al. 2015

IJWHR

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“…Regarding the type of procedure, all included studies used the open myomectomy technique, except nine studies that used either laparoscopic (19)(20)(21)(22)(23)(24)(25) or hysteroscopic (26,27) techniques. In the open myomectomy group, seven studies assessed the role of misoprostol in reducing the blood loss during myomectomy; four studies compared vaginal (28)(29)(30) or rectal misoprostol (31) misoprostol with placebo, and three studies compared a single dose of misoprostol with a tourniquet t(32), bilateral uterine artery ligation (33), or double doses of misoprostol (34).…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Vasopressin, alone or in combination with misoprostol, was effective in reducing blood loss and need for transfusion. Regarding TXA, three studies compared TXA with placebo (39-41), and two studies compared the TXA with uterotonic agents (27,42). The five studies reported a significant reduction of blood loss after topical or intravenous TXA, except for one double-blinded trial, which reported no beneficial role of intravenous TXA in the setting of open myomectomy (41).…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Perioperative nonhormonal pharmacological interventions for bleeding reduction during open and minimally invasive myomectomy: a systematic review and network meta-analysis

Samy

Raslan

Talaat

et al. 2020

Fertility and Sterility

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Objective: To synthesize evidence on the most effective pharmacological interventions for bleeding reduction during open and minimally invasive myomectomy. Design: Systematic review and network meta-analysis of randomized controlled trials (RCTs). Setting: Not applicable. Patients: Trials assessing efficacy of pharmacological interventions during different types of myomectomy. Interventions: Misoprostol, oxytocin, vasopressin, tranexamic acid (TXA), epinephrine, or ascorbic acid. Main Outcome Measures: Intraoperative blood loss and need for blood transfusion. Results: The present review included 26 randomized control trials (RCTs) (N ¼ 1627). For minimally invasive procedures (9 RCTs; 474 patients), network meta-analysis showed that oxytocin (mean difference [MD] À175.5 mL, 95% confidence interval [CI] À30.1.07, À49.93), ornipressin (MD À149.6 mL, 95% CI À 178.22, À120.98), misoprostol, bupivacaine plus epinephrine, and vasopressin were effective in reducing myomectomy blood loss, but the evidence is of low quality. Ranking score of treatments included in subgroup analysis of minimally invasive myomectomy showed that oxytocin ranked first in reducing blood loss, followed by ornipressin. For open myomectomy (17 RCTs; 1,153 patients), network meta-analysis showed that vasopressin plus misoprostol (MD À652.97 mL, 95% CI À 1113.69, À174.26), oxytocin, TXA, and misoprostol were effective; however, the evidence is of low quality. Vasopressin plus misoprostol ranked first in reducing blood loss during open myomectomy (P ¼ .97). Conclusion:There is low-quality evidence to support uterotonics, especially oxytocin, and peripheral vasoconstrictors as effective options in reducing blood loss and need for blood transfusion during minimally invasive myomectomy. Oxytocin is the most effective intervention in minimally invasive myomectomy. For open myomectomy, a combination of uterotonics and peripheral vasoconstrictors is needed to effectively reduce blood loss. (Fertil Steril Ò 2020;113:224-33. Ó2019 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

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Hematological profile and transfusion requirement during hysteroscopic myomectomy: A comparative study between oxytocin and tranexamic acid infusion

Cited by 16 publications

References 20 publications

Effect of oxytocin infusion versus tranexamic acid on reducing blood loss during hysteroscopic myomectomy: a randomized controlled trial

Effect of oxytocin infusion versus tranexamic acid on reducing blood loss during hysteroscopic myomectomy: a randomized controlled trial

Comparison of the Intraoperative Outcomes of Intrauterine Instillation of Epsilon-Aminocaproic Acid and Intravenous Oxytocin in Hysteroscopy Surgeries

Perioperative nonhormonal pharmacological interventions for bleeding reduction during open and minimally invasive myomectomy: a systematic review and network meta-analysis

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