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Comparison Effectiveness of Rectal Misoprostol & Intravenous Tranexamic Acid Reducing Hemorrhage in Myomectomy

Active, not recruiting
Conditions
Hemorrhage, Surgical
Myoma;Uterus
Effect of Drug
Postoperative Hemorrhage
Postoperative Complications
Interventions
Registration Number
NCT06114758
Lead Sponsor
Ankara Etlik City Hospital
Brief Summary

Fibroids are the most commonly encountered tumors in the female reproductive system. In patients, fibroids most often lead to abnormal uterine bleeding and the resulting anemia. In some cases, they can cause infertility or habitual abortions. Another complaint caused by fibroids is pain due to pressure and effects on adjacent organs. Very large fibroids can lead to abdominal swelling. Therefore, if a patient becomes symptomatic due to fibroids, myomectomy or, if necessary, hysterectomy is required.

Because fibroids have a significant blood supply, there is a high risk of intraoperative bleeding and related complications. Additionally, the most common complication in these patients after the operation is bleeding. In many of these patients, intraoperative or postoperative blood transfusions are performed. If bleeding cannot be intervened early in these patients, hemodynamic instability, shock, coagulopathy, and, in the final stage, death can occur due to hemorrhage. Therefore, both intraoperative and postoperative bleeding control is of vital importance in patients undergoing myomectomy.

Detailed Description

In this study, data of patients admitted with a diagnosis of uterine fibroids to the Department of Obstetrics and Gynecology, Women's Health and Obstetrics (EŞH) between September 1, 2022, and Sempember 1, 2024, who underwent myomectomy (either laparotomic or laparoscopic), will be collected.

The parameters to be examined in the research are as follows:

1. Patients' postoperative 1st, 2nd, and 6th-hour vital signs (pulse rate, systolic and diastolic blood pressure, temperature, oxygen saturation).

2. Shock indices.

3. Hemogram and hematocrit values at 6-24 hours postoperatively.

4. Duration of the surgery.

5. Adverse effects experienced by the patients.

6. Additional treatments administered.

7. Whether blood transfusion was performed or not.

In this study, the G-power analysis program was used to determine the minimum sample size, taking into account a 10% margin of error. According to the analysis results, the minimum number of patients to be included in the study for a total of 75 patients across 3 groups was determined. Statistical analysis of the data obtained in the study will be conducted using the SPSS Statistics 22 software package. A 95% confidence interval will be calculated for each variable, and results will be considered statistically significant for p \< 0.05.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
Female
Target Recruitment
75
Inclusion Criteria
  • Patients over 18 years of age
  • Laparotomic myomectomy surgeries
  • Laparoscopic myomectomy surgeries
Exclusion Criteria
  • Identifying missing or suspicious data related to the patient
  • Administering both intraoperative and postoperative medications to the patient

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
intraoperatively admistiration of prostoglandin f2 alfa (cytotec 400 microgram rectal)- group 2Cytotec 200Mcg Tablet1. Patients' postoperative 1st, 2nd, and 6th-hour vital signs (pulse rate, systolic and diastolic blood pressure, temperature, oxygen saturation). 2. Shock indices. 3. Hemogram and hematocrit values at 6-24 hours postoperatively. 4. Duration of the surgery. 5. Adverse effects experienced by the patients. 6. Additional treatments administered. 7. Whether blood transfusion was performed or not.
intraoperatively admistiration of tranexamic acid (1 gram intravenous) - group 2Transamine1. Patients' postoperative 1st, 2nd, and 6th-hour vital signs (pulse rate, systolic and diastolic blood pressure, temperature, oxygen saturation). 2. Shock indices. 3. Hemogram and hematocrit values at 6-24 hours postoperatively. 4. Duration of the surgery. 5. Adverse effects experienced by the patients. 6. Additional treatments administered. 7. Whether blood transfusion was performed or not.
Primary Outcome Measures
NameTimeMethod
Comparison of patients' postoperative shock indices6 hour

postoperative 1st, 2nd, and 6th-hour shock indices (heart rate (beats in minute) / systolic blood pressure(mmHg) ) will be compared

Comparison of patients' preoperative and postoperative hemogram levels24 hours

The basal hemogram levels ( gr/dL) of the patients will be compared with the hemogram levels at 6 and 24 hours.

Comparison of patients' preoperative and postoperative hematocrit levels24 hours

The basal hematocrit levels (%) of the patients will be compared with the hematocrit levels at 6 and 24 hours.

Secondary Outcome Measures
NameTimeMethod
Comparison of the patients' postoperative heart rate6 hour

Patients postoperative 1st, 2nd, and 6th-hour heart rate (beats in minute) will be compared

Comparison of the patients' postoperative systolic and diastolic blood pressure6 hour

Patients postoperative 1st, 2nd, and 6th-hour systolic and diastolic blood pressure (mmHg) will be compared

Trial Locations

Locations (1)

Etlik City Hospital

🇹🇷

Ankara, Turkey

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