Efficacy of Oxytocin in Reducing Blood Loss During Abdominal Myomectomy

Abstract

Introduction: The drug of choice for preventing postpartum uterine atony and bleeding is oxytocin. Myomectomy is a procedure that may result in substantial bleeding. In about 20% women, transfusion of blood may be required during abdominal myomectomy. The objective was to compare the frequency of patients who needed blood transfusions with and without oxytocin during abdominal myomectomy.

Place and duration of study: This was a randomized controlled trial carried out at the Department of Obstetrics and Gynecology of Sharif Medical Complex Lahore from 10^th May 2018 to 10^th November 2018.

Material & Methods: 108 patients having intramural uterine fibroid > 5 cm in size, requiring planned elective open abdominal myomectomy were included and equally divided in both oxytocin and non-oxytocin groups(n=54). 30 IU oxytocin infusion (in 500 ml normal saline) / 120 milliliter per hour were administered during myomectomy, starting after administration of general anesthesia and completing just prior to surgery in patients of oxytocin group. An infusion of pure normal saline was administered at the same amount in the patients of non-oxytocin group. Blood loss was estimated and need for blood transfusion was determined in both the groups. Data was analyzed using SPSS version 24. P-value<0.05 was considered significant.

Results: Patients age ranged from 35 to 45 years with mean age of 40.481± 1.84 years in Oxytocin group while 40.425±

2.68 years in Non-Oxytocin group. Mean blood loss was 290.463±120.91 cc in Oxytocin group and 424.981±106.21 cc in Non-Oxytocin group. Need for blood transfusion was seen in 7.4% patients in Oxytocin group as compared to 25.9% in Non-Oxytocin group (p=0.009).

Conclusion: Our study concludes that to reduce loss of blood during abdominal myomectomy, infusion of intra- operative oxytocin may be efficient and safe. To confirm these results, more studies with varied dosages and protocols are required.