Evaluating Efficacy of Intravenous Carbetocin in Reducing Blood Loss During Abdominal Myomectomy: A Randomized Controlled Trial

Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt. Faculty of Medicine, Al-Azhar University, Cairo, Egypt. Electronic address: ahmedsaidali987@azhar.edu. Department of Obstetrics and Gynecology, Faculty of Medicine, Fayom University, Fayom. Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Reproductive Health and Family Planning Department, National Research Center, Dokki, Egypt; Consultant OB/Gyn, Aljazeerah Hospital, Giza, Egypt. Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt. Department of Obstetrics and Gynecology, Faculty of Medicine, Misr University for Science and Technology, 6th October City, Giza, Egypt. Department of Obstetrics and Gynecology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.

Fertility and sterility. 2021
Abstract
OBJECTIVE To evaluate the efficacy of carbetocin versus placebo in decreasing intraoperative blood loss and the need for blood transfusion during abdominal myomectomy. DESIGN Randomized, double-blind, placebo-controlled trial. SETTING Tertiary university hospital from September 2019 to February 2020. PATIENT(S): A total of 138 women with symptomatic leiomyoma who were candidates for abdominal myomectomy (n = 69 in each group). INTERVENTION(S): We randomized the study participants in a 1:1 ratio to carbetocin and placebo groups. Intravenous 100 μg carbetocin or placebo was administered slowly after induction of anesthesia. MAIN OUTCOME MEASURE(S): Intraoperative blood loss, need for blood transfusion, postoperative hemoglobin, operative time, length of hospitalization, and drug side-effects. RESULT(S): The baseline characteristics were similar among all groups. Carbetocin had significantly lower intraoperative blood loss compared with placebo (mean difference 184 mL). Hemoglobin level 24 hours after surgery was significantly lower in the placebo group than in the carbetocin group (9.1 ± 0.8 vs. 10.3 ± 0.6 g/dL). Eight women in the carbetocin group needed blood transfusion compared with 17 in placebo group. Operative time, length of hospitalization, and side-effects were similar in both groups. CONCLUSION(S): A single preoperative intravenous dose of 100 μg carbetocin is a simple, practical, and effective method of decreasing intraoperative blood loss and the need for blood transfusion during abdominal myomectomy, with tolerable, few, nonsignificant side-effects. CLINICAL TRIAL REGISTRATION NUMBER NCT04083625.
Study details
Language : eng
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