Intravenous versus intramyometrial injection of carbetocin for reduction of blood loss during myomectomy operation

https://doi.org/10.53730/ijhs.v6nS5.11425

Authors

  • Abdallah Mahmoud Sayed Obstetrics and Gynecology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
  • Nareman Mohammed El-Hamamy Obstetrics and Gynecology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
  • Ayman Abd-elaziz EL-Dorf Obstetrics and Gynecology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
  • Tarek Mohammed El-Sabae El-Hawary Obstetrics and Gynecology Department, Faculty of Medicine, Tanta University, Tanta, Egypt

Keywords:

intravenous injection, intramyometrial injection, carbetocin, blood loss, myomectomy operation

Abstract

Background: Leiomyomas cause significant morbidity due to abnormal uterine bleeding and pelvic pressure symptoms. Carbetocin is a long-acting synthetic agonist analogue of the human oxytocin which induces uterine contractions. The study aims to compare intravenous carbetocin clinical effect and its myometrial injection to decrease blood loss in myomectomy operation. Methods: This randomized controlled study involved 60 patients who clinically and sonographically diagnosed with single intramural fibroids. Patients were allocated into three equal groups: Group A (Intravenous cabetocin group), group B (Myometrial carbetocin group) and group C (Control group). All patients underwent abdominal ultra-sonography, routine laboratory investigation. Results: The blood loss was more in-group B than the group A with high significant difference between the three groups (P<0.001). Preoperatively there was significant difference in Hb between the three groups (0.002), but postoperatively there was insignificant difference in Hb between the three groups both groups. Conclusions: The use of intravenous carbetocin injection during preoperative abdominal myomectomy operation is more effective in decreasing the blood loss, shorter operative time, decreasing blood transfusion and rapid postoperative recovery than the use intramyometrial Carbetocin injection.

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References

Ryan GL, Syrop CH, Van Voorhis BJ. Role, epidemiology, and natural history of benign uterine mass lesions. Clin Obstet Gynecol. 2005;48:312-24.

Wallach EE, Vlahos NF. Uterine myomas: an overview of development, clinical features, and management. Obstet Gynecol. 2004;104:393-406.

Sankaran S, Manyonda IT. Medical management of fibroids. Best Pract Res Clin Obstet Gynaecol. 2008;22:655-76.

Parker WH. Etiology, symptomatology, and diagnosis of uterine myomas. Fertil Steril. 2007;87:725-36.

Sohn GS, Cho S, Kim YM, Cho CH, Kim MR, Lee SR. Current medical treatment of uterine fibroids. Obstet Gynecol Sci. 2018;61:192-201.

Zimmermann A, Bernuit D, Gerlinger C, Schaefers M, Geppert K. Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women. BMC Womens Health. 2012;12:6-15.

Gupta S, Jose J, Manyonda I. Clinical presentation of fibroids. Best Pract Res Clin Obstet Gynaecol. 2008;22:615-26.

Sparic R, Mirkovic L, Malvasi A, Tinelli A. Epidemiology of uterine myomas: A review. Int J Fertil Steril. 2016;9:424-35.

Okolo S. Incidence, aetiology and epidemiology of uterine fibroids. Best Pract Res Clin Obstet Gynaecol. 2008;22:571-88.

Reis FM, Bloise E, Ortiga-Carvalho TM. Hormones and pathogenesis of uterine fibroids. Best Pract Res Clin Obstet Gynaecol. 2016;34:13-24.

Chandran S, Cairns MT, O'Brien M, O'Connell E, Mashayekhi K, Smith TJ. Effects of combined progesterone and 17β-estradiol treatment on the transcriptome of cultured human myometrial smooth muscle cells. Physiol Genomics. 2016;48:50-61.

Lethaby A, Vollenhoven B, Sowter M. Pre-operative GnRH analogue therapy before hysterectomy or myomectomy for uterine fibroids. Cochrane Database Syst Rev. 2001:54-9.

Vessey MP, Villard-Mackintosh L, Mcpherson K, Coulter A, Yeates D. The epidemiology of hysterectomy: findings in a large cohort study. BJOG. 1992;99:402-7.

Namimoto T, Yamashita Y, Awai K, Nakaura T, Yanaga Y, Hirai T, et al. Combined use of T2-weighted and diffusion-weighted 3-T MR imaging for differentiating uterine sarcomas from benign leiomyomas. Eur Radiol. 2009;19:2756-64.

Thomassin-Naggara I, Dechoux S, Bonneau C, Morel A, Rouzier R, Carette MF, et al. How to differentiate benign from malignant myometrial tumours using MR imaging. Eur Radiol. 2013;23:2306-14.

Davidson B, Abeler VM, Førsund M, Holth A, Yang Y, Kobayashi Y, et al. Gene expression signatures of primary and metastatic uterine leiomyosarcoma. Hum Pathol. 2014;45:691-700.

Mohamed A, Saeed A, Taha M. Comparative study of the effect of intramyometrial carbetocin injection and rectal misoprostol on blood loss during myomectomy operations. Al-Azhar Assiut Med J. 2021;19:539-47.

Aslan Çetin B, Aydoğan Mathyk B, Köroğlu N, Soydar A, Demirayak G, Çift T. Oxytocin infusion reduces bleeding during abdominal myomectomies: a randomized controlled trial. Arch Gynecol Obstet. 2019;299:151-7.

Sallam HF, Shady NW. Intravenous carbetocin to decrease blood loss during open myomectomy: a randomized placebo-controlled study. Int J Reprod Contracept Obstetr Gynecol. 2017;7:27-32.

Taher A, Farouk D, Mohamed Kotb MM, Ghamry NK, Kholaif K, A AMAA, et al. Evaluating efficacy of intravenous carbetocin in reducing blood loss during abdominal myomectomy: a randomized controlled trial. Fertil Steril. 2021;115:793-801.

Helal AS, Abdel-Hady el S, Refaie E, El Shamy M, El Fattah RA, Mashaly Ael M. Preliminary uterine artery ligation versus pericervical mechanical tourniquet in reducing hemorrhage during abdominal myomectomy. Int J Gynaecol Obstet. 2010;108:233-5.

Lawrie TA, Rogozińska E, Sobiesuo P, Vogel JP, Ternent L, Oladapo OT. A systematic review of the cost-effectiveness of uterotonic agents for the prevention of postpartum hemorrhage. Int J Gynaecol Obstet. 2019;146:56-64.

Published

01-08-2022

How to Cite

Sayed, A. M., El-Hamamy, N. M. . ., EL-Dorf, A. A.- elaziz, & El-Hawary, T. M. E.-S. (2022). Intravenous versus intramyometrial injection of carbetocin for reduction of blood loss during myomectomy operation. International Journal of Health Sciences, 6(S5), 12387–12395. https://doi.org/10.53730/ijhs.v6nS5.11425

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Section

Peer Review Articles