Abstract
Author(s): Marwan Mohamed Gamal*, Sherif Fathy El-Mekawi, Ahmed Mohamed Bahaa El-Din and Rasha Mahmoud Medhat Abdul Hadi
Background: Carbetocin works as an oxytocic, antihemorrhagic and uterotonic drug in the peripheral nervous system. Carbetocin functions as an agonist at peripheral oxytocin receptors, particularly in the myometrium commonly known as a fibroid.
Aim of the Work: To compare the efficacy of intravenous 100 microgram carbetocin vs. uterine tourniquet to reduce intraoperative blood loss in open myomectomy.
Patients and Methods: This current study was a randomized controlled trial, carried out on 110 women who underwent myomectomy at Ain Shams University Maternity hospital. Group A included 55 of the patients who received 100 microgram of carbetocin IV intraoperative and Group B included 55 patients with uterine artery tourniquet was done.
Results: Reduction in Hemoglobin was significantly less in Group B than Group A (p<0.001), with no significant difference between the two groups as regards Preoperative Hematocrit (p=.50). Postoperative Hematocrit, was significantly higher in Group B than Group A (p<0.001). Reduction in Hematocrit was significantly less in Group B than in Group A (p<0.001). The need for blood transfusion was not significantly different between the two groups (p= 0.49).
Conclusion: Despite proven by different studies that the use of carbetocin during open myomectomy whether intravenous or intramyometrial decreases the intraoperative blood loss, the use of uterine artery tourniquet in our study seems to be more effective method that significantly decrease bleeding and allows proper hemostasis during this operation.