| Autor: |
Abu-Zaid A; College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia., Al Baalharith M; Department of Obstetrics and Gynecology, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia., Alsabban M; Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia., Alomar O; College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia.; Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia., Abuzaid M; Department of Obstetrics and Gynecology, Al Birk General Hospital, Al Birk 63525, Saudi Arabia., Alsehaimi SO; Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia., Albelwi H; Department of Obstetrics and Gynecology, National Guard Hospital, Riyadh 14611, Saudi Arabia., Alqarni SMS; Department of Obstetrics and Gynecology, King Faisal Armed Forces Hospital, Khamis Mushait 62413, Saudi Arabia., Alqahtani MA; Department of Obstetrics and Gynecology, King Faisal Medical City for Southern Regions, Abha 62527, Saudi Arabia., Jamjoom MZ; Department of Obstetrics and Gynecology, King Fahad Armed Forces Hospital, Jeddah 23311, Saudi Arabia., Baradwan S; Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah 23433, Saudi Arabia., Sabban H; Department of Obstetrics and Gynecology, Faculty of Medicine at Rabigh, King Abdulaziz University, Jeddah 21589, Saudi Arabia., Himayda S; Department of Obstetrics and Gynecology, Faculty of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia., Albouq B; Department of Obstetrics and Gynecology, Prince Mohammed Bin Abdulaziz National Guard Hospital, Madinah 42324, Saudi Arabia., Badghish E; Department of Obstetrics and Gynecology, Maternity and Children Hospital, Makkah 24246, Saudi Arabia., Baradwan A; Department of Obstetrics and Gynecology, Al Salama Hospital, Jeddah 22233, Saudi Arabia., Sindi R; Faculty of Pharmacy, Umm Al-Qura University, Makkah 24381, Saudi Arabia., Al-Badawi IA; College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia.; Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia. |
| Abstrakt: |
Objective : This study offered an updated meta-analysis of randomized controlled trials (RCTs) that assessed preoperative misoprostol compared to control (matched placebos or no treatment) during abdominal myomectomies. Methods : Six databases underwent screening until 7 April 2024. The risk of bias was assessed using the Cochrane Collaboration tool. The results were presented as mean differences (MDs) or risk ratios (RRs) along with 95% confidence intervals (CIs) using the random-effects model. Results : Sixteen RCTs were analyzed, involving 975 women. The overall quality of the studies was rated as "low" or had "some concerns" of bias in seven and eight RCTs, respectively; one RCT had an overall "high" risk of bias. For primary endpoints, the misoprostol intervention had significantly lower mean intraoperative blood loss (n = 15, MD = -180.2 mL, 95% CI [-224.04, -136.35], p < 0.001), mean hemoglobin drop (n = 13, MD = -0.58 g/dl, 95% CI [-0.82, -0.35], p < 0.001), and rate of perioperative blood transfusion (n = 13, RR = 0.43, 95% CI [0.29, 0.63], p < 0.001) compared to the control intervention. For secondary endpoints, the misoprostol intervention had significantly lower mean hematocrit drop (MD = 2.15, 95% CI -3.34, -0.96], p < 0.001), mean operative time (MD = -12.95 min, 95% CI [-19.89, -6.01], p < 0.001), and mean hospital stay (MD = -0.14 days, 95% CI [-0.25, -0.02], p = 0.02) compared to the control intervention. Nonetheless, no significant change was indicated between both interventions regarding the rate of postoperative fever. Conclusions : During abdominal myomectomy, the administration of preoperative misoprostol was generally safe and yielded statistically significant reductions in intraoperative blood loss, hemoglobin drop, and perioperative blood transfusion. |
