use of single versus double dose of intra-vaginal prostaglandin E[2] "misoprostol" prior to abdominal myomectomy: a randomized controlled clinical trial

ABSTRACT

The study aimed to investigate the effectiveness of a single versus double dose of prostaglandin E[2] "misoprostol, 400 microgram" prior to myomectomy for multiple uterine fibroids. This was a prospective randomized controlled trial comprised of 69 patients with multiple myomas undergoing myomectomy. Patients received either an intra-vaginal single dose of 400 microgram misoprostol 1 hr pre-operatively [group A, 34 cases] or 2 doses, 3 and 1 hr prior to surgery [group B, 35 cases]. Operation time, intra and post-operative blood loss, hemoglobin concentration, blood pressure and body's temperature were estimated and compared in both groups. The data were statistically analyzed using chi-square test. The p<0.05 was considered significant. In group B, the mean operative time was significantly [p<0.001] shorter than in group A [25.8 +/- 4.14 vs. 35.4 +/- 5.6 min respectively]. The mean value for operative blood loss was significantly [p<0.001] smaller in group B [101.4 +/- 25.5 vs. 200.16 +/- 18.8 ml]. There was a significant [p<0.01] rise of the body temperature in group B [38.5 +/- 0.7 vs. 37.18 +/- 0.84°C]. There were no differences between the two groups regarding hemoglobin levels, post-operative febrile morbidity or length of hospital stay. In this study, two doses of pre-operative intra-vaginal misoprostol were more effective than one dose in reducing intra and post-operative blood loss and shortening of operation time during abdominal myomectomy