• Fung-Wei Chang, Mu-Hsien Yu, Chih-Hung Ku, Chi-Huang Chen, Gwo-Jang Wu, and Jah-Yao Liu.
• Department of Obstetrics and Gynecology, Tri-service General Hospital, National Defense Medical Center, National Defense University, Neihu, Taipei, Taiwan.
• BJOG. 2006 Jan 1;113(1):47-52.

ObjectiveTo investigate the effectiveness of uterotonics misoprostol and oxytocin on reducing blood loss during laparoscopy-assisted vaginal hysterectomy (LAVH).DesignRandomised, double-blind placebo-controlled trial.SettingUniversity hospital.PopulationOne hundred and seventy-three women underwent LAVH for symptomatic uterine myomas and were randomly allocated to uterotonics (n = 91) or placebo (n = 82).MethodsWomen underwent LAVH for symptomatic uterine myomas and were randomly assigned to receive either rectal misoprostol (400 microg) and intravenous oxytocin (10 IU/hour) or placebo during LAVH. Parameters related to surgical outcome were compared.Main Outcome MeasuresThe main outcome measure was intra-operative blood loss.ResultsPatient characteristics and indications for LAVH were similar in both groups. Mean [SD] for all continuous data estimated weight of blood loss (198.1 [123.2] vs 396 [337.6] g; P < 0.0001), mean operation time (106.2 [39.4] vs 116.6 [34.6] minutes; P = 0.02), mean change in haemoglobin (1.5 [1.0] vs 1.9 [1.2] g/dL; P = 0.02) and haematocrit levels (4.8 [2.9]% vs 5.8 [3.6]%; P = 0.04) and mean hospitalisation period (3.3 [0.8] vs 3.9 [1.1] days; P < 0.0001), which were significantly less in the group given rectal misoprostol and intravenous oxytocin than in the placebo group, respectively. There was no significant difference in complications and side effects between the two groups (P > 0.05).ConclusionCombined rectal misoprostol and intravenous oxytocin is a feasible and effective method of reducing blood loss and operation time in LAVH.

31 keywords...

hide…