2998 Reproductive Outcomes after the use of Tourniquet in Abdominal Myomectomy

Abstract

Study Objective To determine whether the pregnancy rate and live birth rate is similar in women of childbearing age undergoing abdominal myomectomy (AM) in two major Canadian urban centers with the use of a peri-cervical tourniquet compared to women undergoing AM without the use of a tourniquet. Design A multi-center retrospective cohort study was conducted, consisting of a retrospective chart review and a self-administered study questionnaire on reproductive outcomes. Setting Sunnybrook Health Sciences Center and St. Michael's Hospital, two tertiary care centers affiliated with the University of Toronto. Patients or Participants Women of childbearing age (18-45 years old) who underwent AM between June 2002 and 2012 were consecutively sampled. 1099 patients met inclusion criteria and 144 returned the study questionnaire. After excluding patients who did not attempt to conceive post-operatively, 82 patients were included in the final statistical analysis. Interventions Use of a peri-cervical tourniquet during AM. Measurements and Main Results Unadjusted and multivariable regression analysis was used to compare the groups of patients. Mean age of patients at time of surgery was 36 years. 28% of surgeries involved use of peri-cervical tourniquet. There was no significant association between the use of tourniquet and live birth rate (p=0.35). Similarly, there was no significant difference between the use of tourniquet and length of time attempting conception after surgery (p=0.91). Data analysis is ongoing and further results will be presented. Conclusion Our study suggests no significant association between use of tourniquet and live birth outcomes. Concerns about the tourniquet's impact on fertility may therefore be unfounded, and a more widespread uptake of peri-cervical tourniquet during AM may contribute to limiting surgical blood loss. Further prospective research is warranted with a larger sample size.