Interventions to reduce haemorrhage during myomectomy for fibroids

Abstract

Some women have non-cancerous growths of the uterus called fibroids. In a third of cases the fibroids produce symptoms, such as vaginal bleeding, that warrant treatment. The surgical removal of the fibroids, called myomectomy, is one of the treatment options for fibroids. It can be accomplished by either laparotomy (through an incision into the abdomen) or laparoscopy (keyhole surgery). The procedure is associated with heavy bleeding. Many interventions have been used to reduce bleeding during the operation for removing fibroids but the authors found only few studies that assessed their effectiveness. The limited data available suggest that some of these medications, such as the use of tourniquets (cords tied round blood vessels that supply the uterus), chemical dissection (removal of fibroids with the aid of a chemical substance that breaks down tissues), misoprostol (medication that arrests bleeding by causing contraction of muscles of the uterus), and tranexamic acid (medication that prevents bleeding by inhibiting the breakdown of blood clots) are effective in reducing bleeding during myomectomy