Role of Vasopressin Injection Intramyometrial in Decreasing Blood Loss During Abdominal Myomectomy (A Randomized Controlled Trial)

Abstract

Background: Abdominal myomectomy is a major operation. Massive blood loss is the most serious complication which should be taken in consideration to decrease morbidity and mortality. There are several modalities to decrease blood loss approached in different studies as preoperative GnRh, uterine artery tourniquet, tranexamic acid, vasopressin …etc.Aim: The aim of the study was to assess the role of vasopressin injection intramyometrial in decreasing blood loss during abdominal myomectomy. The study was done on women who were scheduled for abdominal myomectomy in Ain-Shams University Maternity Hospital.Materials and Methods: This study is a randomized clinical trial study which was conducted at Ain-Shams University Maternity Hospital on 60 women with uterine fibroid admitted for abdominal myomectomy to detect if vasopressin injection intramyometrial had a role in decreasing blood loss versus placebo or not.Results: The end results showed that that the mean of blood loss was 826.67cc with standard deviation 185.94 and 115.53cc with standard deviation 23.17 at control and vasopressin group respectively with p- value <0.001 which indicates that there a highly significant difference in blood loss between two groups. The mean reduction in hemoglobin was1.38 and 0.08 g/dl in control and vasopressin group respectively with p- value < 0.002 which showed that there was a significant difference between them, only 30% of the control group need blood transfusion and no need for transfusion in the vasopressin group.Conclusion:Intramyometrial vasopressin injection during abdominal myomectomy may effectively decreases the blood loss, need for blood transfusion and it causes less reduction in haemoglobin and haematocrit. Thereby it seems to be an effective method without having any risk of ischemic damage to the uterus.