Interventions to reduce haemorrhage during myomectomy for fibroids

Effect of oxytocin infusion on reducing the blood loss during abdominal myomectomy: a double‐blind randomised controlled trial

“…Uterine leiomyomas (fibroids) are the most common benign tumours among women. 1 Fibroids are found in approximately 20% of women over 35 years of age. 2 In 20-50% of patients, fibroids may cause problems such as heavy menstrual bleeding, anaemia, pelvic pain and pressure, and symptoms from extrinsic compression of the colorectal and urinary tract.…”

“…2 In 20-50% of patients, fibroids may cause problems such as heavy menstrual bleeding, anaemia, pelvic pain and pressure, and symptoms from extrinsic compression of the colorectal and urinary tract. [1][2][3] Surgery is indicated for symptomatic uterine leiomyomas; hysterectomy for women who have completed childbearing (women > 40 years old), and myomectomy for women <40 years old who wish to preserve uterine and fertility. 4 Myomectomy can be accomplished by laparotomy, laparoscopy, or hysteroscopy (transvaginal) 1,[5][6][7][8] approaches.…”

Nesa Days 2015, Conference Report

“…All these changes reversed spontaneously during the myomectomy, with no ill effects on the patients. Thus, in their conclusions, authors reported that Vasopressin causes profound but reversible cardiovascular changes [81]. In the group of patients studied, who were relatively young and healthy, such hemodynamic changes have no significant negative sequelae, and vasopressin is therefore a safe and effective agent for minimizing blood loss.…”

Prospective randomised trial comparing gonadotrophin‐releasing hormone analogues with triple tourniquets at open myomectomy Authors' Reply

“…Finally, while the value of intramyometrial injections of vasopressin and its derivatives in terms of reducing the need for blood transfusion at myomectomy is debatable, 4,5 there is no debate regarding its risks of causing lifethreatening complications even when using the dilute solution recommended by Talaulikar et al 1 Furthermore, because of their short half-life, injectable vasoconstrictors can mask bleeding vessels during surgery resulting in suboptimal uterine repair and bleeding after surgery. Tourniquets do not have any of these short comings.…”