Assessment of carboprost tromethamine for reducing hemorrhage in laparoscopic intramural myomectomy

  • Authors:
    • Ruitao Zhang
    • Huirong Shi
    • Fang Ren
    • Zhongfu Yuan
  • View Affiliations

  • Published online on: July 20, 2015     https://doi.org/10.3892/etm.2015.2649
  • Pages: 1171-1174
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Abstract

The aim of the present study was to evaluate the effect of carboprost tromethamine on blood loss during laparoscopic myomectomy (LM) in females. Ninety women, who were scheduled for LM due to symptomatic uterine myomas, were randomly divided into three groups. Twenty‑four women were intramyometrially injected with 12 IU diluted vasopressin (vasopressin group), 30 cases received a deep intramuscular injection of 250 µg carboprost tromethamine 30 min prior to myomectomy (carboprost group), and 36 cases received an intramuscular injection of 250 µg carboprost tromethamine followed by a 20 IU oxytocin intravenous infusion at a rate of 120 mU/min during the procedure (carboprost plus oxytocin group). The procedure time, amount of hemorrhage, postoperative reduction in hemoglobin levels, adverse effects, bowel deflation time and time of postoperative hospital stay were compared. The procedure time, amount of hemorrhage and postoperative reduction in hemoglobin levels were not significantly different between the carboprost group and the vasopressin group (P>0.05). In the carboprost plus oxytocin group, the procedure time, amount of hemorrhage and postoperative reduction in hemoglobin levels were 24.3±2.6 min, 51.1±8.4 ml and 6.9±1.5 g/l, respectively, which were significantly less than those in the vasopressin and carboprost groups (all P<0.05). In the carboprost and carboprost plus oxytocin groups, the incidence of mild uterine contraction pain was significantly higher than in the vasopressin group (χ2=12.913, P=0.002). The incidences of other side‑effects were not significantly different among the three groups. The times for bowel deflation and postoperative hospital stay were marginally increased in both the carboprost and carboprost plus oxytocin groups, compared with the vasopressin group, although no significant differences were found among the three groups (P>0.05). Deep intramuscular injections of carboprost tromethamine prior to performing myomectomy could be an effective approach for reducing blood loss from intramural LM, in particular when combined with oxytocin intravenous infusion.

References

1 

Kongnyuy EJ and Wiysonge CS: Interventions to reduce haemorrhage during myomectomy for fibroids. Cochrane Database Syst Rev. 8:CD0053552014.PubMed/NCBI

2 

Rovio PH and Heinonen PK: Transvaginal myomectomy with screw traction by colpotomy. Arch Gynecol Obst. 273:211–215. 2006. View Article : Google Scholar

3 

Fukuda M, Tanaka T, Kamada M, Hayashi A, Yamashita Y, Terai Y and Ohmichi M: Comparison of the perinatal outcomes after laparoscopic myomectomy versus abdominal myomectomy. Gynecol Obstet Invest. 76:203–208. 2013. View Article : Google Scholar : PubMed/NCBI

4 

Soto E, Flyckt R and Falcone T: Endoscopic management of uterine fibroids: An update. Minerva Ginecol. 64:507–520. 2012.PubMed/NCBI

5 

Trehan N: Laparoscopic myomectomy: Methods to control bleeding. J Gynecol Endosc Surg. 2:33–35. 2011. View Article : Google Scholar : PubMed/NCBI

6 

Wang CJ, Lee CL, Yuen LT, Kay N, Han CM and Soong YK: Oxytocin infusion in laparoscopic myomectomy may decrease operative blood loss. J Minim Invasive Gynecol. 14:184–188. 2007. View Article : Google Scholar : PubMed/NCBI

7 

Shimanuki H, Takeuchi H, Kitade M, Kikuchi I, Kumakiri J and Kinoshita K: The effect of vasopressin on local and general circulation during laparoscopic surgery. J Minim Invasive Gynecol. 13:190–194. 2006. View Article : Google Scholar : PubMed/NCBI

8 

Bai J, Sun Q and Zhai H: A comparison of oxytocin and carboprost tromethamine in the prevention of postpartum hemorrhage in high-risk patients undergoing cesarean delivery. Exp Ther Med. 7:46–50. 2014.PubMed/NCBI

9 

Matsuoka S, Kikuchi I, Kitade M, Kumakiri J, Kuroda K, Tokita S, Kuroda M and Takeda S: Strategy for laparoscopic cervical myomectomy. J Minim Invasive Gynecol. 17:301–305. 2010. View Article : Google Scholar : PubMed/NCBI

10 

Zhao F, Jiao Y, Guo Z, Hou R and Wang M: Evaluation of loop ligation of larger myoma pseudocapsule combined with vasopressin on laparoscopic myomectomy. Fertil Steril. 95:762–766. 2011. View Article : Google Scholar : PubMed/NCBI

11 

Buttino L Jr and Garite TJ: The use of 15 methyl F2 alpha prostaglandin (Prostin 15 M) for the control of postpartum hemorrhage. Am J Perinatol. 3:241–243. 1986. View Article : Google Scholar : PubMed/NCBI

12 

Abdel-Aleem H, Abol-Oyoun EM, Moustafa SA, Kamel HS and Abdel-Wahab HA: Carboprost trometamol in the management of the third stage of labor. Int J Gynaecol Obstet. 42:247–250. 1993. View Article : Google Scholar : PubMed/NCBI

13 

Vaid A, Dadhwal V, Mittal S, Deka D, Misra R, Sharma JB and Vimla N: A randomized controlled trial of prophylactic sublingual misoprostol versus intramuscular methyl-ergometrine versus intramuscular 15-methyl PGF2 alpha in active management of third stage of labor. Arch Gynecol Obstet. 280:893–897. 2009. View Article : Google Scholar : PubMed/NCBI

14 

Hauksson A, Akerlund M and Melin P: Uterine blood flow and myometrial activity at menstruation, and the action of vasopressin and a synthtic antagonist. Br J Obstet Gynaecol. 95:898–904. 1988. View Article : Google Scholar : PubMed/NCBI

15 

Caras SD, Soykan I, Beverly V, Lin Z and McCallum RW: The effect of intravenous vasopressin on gastric myoelectrical activity in human subjects. Neurogastroenterol Motil. 9:151–156. 1997. View Article : Google Scholar : PubMed/NCBI

16 

Bankir L, Bouby N and Ritz E: Vasopressin: A novel target for the prevention and retardation of kidney disease? Nat Rev Nephrol. 9:223–239. 2013. View Article : Google Scholar : PubMed/NCBI

17 

Tehseen F, Anwar A and Arfat Y: Intraumbilical veinous injection oxytocin in the active management of third stage of labour. J Coll Physicians Surg Pak. 18:551–554. 2008.PubMed/NCBI

18 

Ozalp E, Tanir HM and Sener T: Dinoprostone vaginal insert versis intravenous oxytocin to reduce postpartum blood loss following vaginal or cesarean delivery. Clin Exp Obstet Gynecol. 37:53–55. 2010.PubMed/NCBI

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APA
Zhang, R., Shi, H., Ren, F., & Yuan, Z. (2015). Assessment of carboprost tromethamine for reducing hemorrhage in laparoscopic intramural myomectomy. Experimental and Therapeutic Medicine, 10, 1171-1174. https://doi.org/10.3892/etm.2015.2649
MLA
Zhang, R., Shi, H., Ren, F., Yuan, Z."Assessment of carboprost tromethamine for reducing hemorrhage in laparoscopic intramural myomectomy". Experimental and Therapeutic Medicine 10.3 (2015): 1171-1174.
Chicago
Zhang, R., Shi, H., Ren, F., Yuan, Z."Assessment of carboprost tromethamine for reducing hemorrhage in laparoscopic intramural myomectomy". Experimental and Therapeutic Medicine 10, no. 3 (2015): 1171-1174. https://doi.org/10.3892/etm.2015.2649