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A systematic review of randomized controlled trials to reduce hemorrhage during myomectomy for uterine fibroids

Kongnyuy, Eugene J, Van Den Broek, Nynke ORCID: https://orcid.org/0000-0001-8523-2684 and Wiysonge, C. S. (2008) 'A systematic review of randomized controlled trials to reduce hemorrhage during myomectomy for uterine fibroids'. International Journal of Gynecology & Obstetrics, Vol 100, Issue 1, pp. 4-9.

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Abstract

Objective: To assess the effectiveness and safety of interventions to reduce blood loss during myomectomy. Methods: Electronic searches of the Cochrane Library, MEDLINE, and EMBASE, between 1966 and 2006 for randomized controlled trials (RCTs). Results: We found significant reductions in blood toss with vaginal misoprostol (weighted mean difference [WMD] -149.00 mL, 95% confidence interval [CI] -229.24 to -68.76); intramyometrial vasopressin and analogues (WMD -298.72 mL, 95% CI -593.10 to -4.34); intramyometrial bupivacaine plus epinephrine (WMD -68.60 mL, 95% CI -93.69 to -43.51); and pericervical tourniquet (WMD -1870.00 mL, 95% CI -2547.16 to -1192.84). There was no evidence of effect in blood toss with myoma enucleation by morcellation and oxytocin. Conclusion: There is limited evidence from a few RCTs that some interventions may reduce bleeding during myomectomy. There is need for adequately powered RCTs to shed more light on the effectiveness, safety, and cost of different interventions to reduce blood loss during myomectomy. (c) 2007 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Item Type: Article
Uncontrolled Keywords: myomectomy hemorrhage tourniquet misoprostot oxytocin vasopressin uterine fibroids laparoscopic myomectomy abdominal myomectomy blood-loss vasopressin tourniquet oxytocin ligation uterus myoma
Subjects: WO Surgery > WO 100 General works
WO Surgery > WO 178 Principles of surgical care
WO Surgery > Operative Surgical Procedures. Techniques > WO 500 General works on surgical procedures
WP Gynecology > WP 100 General works
WP Gynecology > WP 20 Research (General)
WP Gynecology > Anatomy. Diseases. Injuries > WP 400 General works
WP Gynecology > Anatomy. Diseases. Injuries > WP 565 Fertility
Faculty: Department: Groups (2002 - 2012) > Child & Reproductive Health Group
Digital Object Identifer (DOI): https://doi.org/10.1016/j.ijgo.2007.05.050
Depositing User: Users 19 not found.
Date Deposited: 11 Aug 2010 14:45
Last Modified: 06 Feb 2018 13:00
URI: https://archive.lstmed.ac.uk/id/eprint/832

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