POMMS: Pre-Operative Misoprostol in Myomectomy Surgery: A Randomised
Controlled Clinical Trial
Abstract
Objective To assess the effect on intra-operative blood loss of using
pre-operative sublingual misoprostol in abdominal and laparoscopic
myomectomy surgeries compared to placebo. Design Double-blind
placebo-controlled randomised study. Setting A single tertiary
Gynaecology Unit in Melbourne, Australia. Population Women 18 years old
undergoing laparoscopic or open myomectomy surgery. Methods Fifty three
women undergoing laparoscopic or abdominal myomectomy surgery for
symptomatic uterine leiomyomas were randomised to pre-operative
sublingual 400mcg misoprostol (n=26) or placebo (n=27). Main Outcome
Measures The primary outcome measure was intra-operative blood loss.
Results There was no significant difference in intra-operative blood
loss at myomectomy surgery between the misoprostol and placebo groups.
Intraoperative blood loss in the misoprostol treatment group was 306ml
+/- 281ml, compared to 325 352 ml in the placebo group; P=0.83. Both
groups were adequately matched for baseline demographics and myoma size.
Conclusions The study was not able to demonstrate that pre-operative
sublingual misoprostol use at laparoscopic and abdominal myomectomy
surgery resulted in a statistically significant reduction in
intra-operative blood loss. This study provides a foundation for
adequately powered trials assessing the effect of sublingual misoprostol
on blood loss at myomectomy. Funding Funding was supplied via an
Australia Gynaecological Endoscopy and Surgery Society (AGES) Research
Grant. There were no conflicts of interest in this trial. Keywords
Leiomyoma, myomectomy, misoprostol, blood loss, sublingual Tweetable
abstract Pre-operative sublingual misoprostol may reduce intra-operative
blood loss during myomectomy surgery but confirmation is required from a
larger study.