The Effect of Sublingual Misoprostol on Bleeding During Abdominal Myomectomy Surgery: A Clinical Trial Study; [یسرربریثأتیورادلوتسورپوزیمینابزریزردنازیمیزیرنوخنیح یحارجیموتکمویم:یمکشکیهعلاطمییامزآراکینیلاب] Publisher

Summary: Can misoprostol reduce bleeding during fibroid surgery? A randomized trial found fewer transfusions and shorter stays, but more nausea and chills. #Gynecology #ClinicalTrials

Lesani Z ; Shakerardekani Z ; Teymoordash S N ; Moradpanah S
Source: Iranian Journal of Obstetrics, Gynecology and Infertility Published:2026

Abstract

Introduction: Misoprostol, a prostaglandin E1 analog, has been proposed to reduce uterine bleeding due to its contractile effects on the uterine myometrium. The present study was conducted with aim to investigate the effect of sublingual administration of misoprostol in reducing bleeding during abdominal myomectomy. Methods: This triple-blind, randomized clinical trial study was conducted in 2024-2025 on 96 women aged 20 to 39 years who were candidates for abdominal myomectomy at Shariati Hospital, Tehran. Participants were randomly divided into two equal groups receiving 400 micrograms of sublingual misoprostol or placebo, which was administered 1 hour before the skin incision. The volume of intraoperative bleeding was estimated by collecting blood in the suction and calculating the amount of blood absorbed in the gauze and pads. The decrease in hemoglobin, the need for blood transfusion, and drug side effects were also recorded. Data were analyzed using SPSS (version 22) and independent t-test, analysis of covariance (ANCOVA), and chi-square test. P<0.05 was considered significant. Results: The results showed that the mean bleeding volume in the intervention group was 144 ml less than the control group (345 ± 128 vs. 489 ± 167 ml; p<0.001). The decrease in Hb and Hct in the intervention group at 24 hours after surgery was 1.2 ± 0.6 g/dL and 3.5 ± 1.1, respectively, which was significantly different from the control group (2.1 ± 0.8 g/dL and 5.8 ± 1.6) (p<0.001). The duration of surgery in the intervention group was 13 minutes shorter (p=0.015) and the length of stay in the hospital was 0.7 days shorter (p=0.003). The need for blood transfusion was significantly reduced in the intervention group (4.2% vs. 18.8%; p=0.021). However, the incidence of some adverse complications such as nausea (25% vs. 10.4%) and chills (16.7% vs. 4.2%) was higher in the intervention group (p<0.05). Conclusion: According to the results obtained, misoprostol can be used as an effective and safe adjunctive method in the management of bleeding during abdominal myomectomy. © 2026, Mashhad University of Medical Sciences. All rights reserved.