The Comparison of Intravenous Tranexamic Acid with Intravenous Oxytocin Effect on the Amount of Bleeding during Hysteroscopic Myomectomy in Women with Abnormal Uterine Bleeding

Backgrounds: Abnormal uterine bleeding is one of the most common causes of women who referring to gynecology clinics .One of the treatments approaches is removal of myoma by hysteroscopy. For reduction of bleeding volume during hysteroscopic myomectomy, several measures were performed. The aim of this study was to compare the effects of tranexamic acid and oxytocin on bleeding during hysteroscopic myomectomy in women with abnormal uterine bleeding.Material and method: This study was conducted on patients undergoing hysteroscopy in Alzahra Medical Center. By consideration of inclusion and exclusion criteria, 92 patients were selected. After general anesthesia, and upon insertion of the hysteroscope into the uterus, 46 patients in first group received 10 mg/kg of tranexamic acid in 500 ml of Ringer's serum at 10 ml per minute intravenous infusion, and for 46 patients in second group, 5 units of oxytocin were administered in 500 ml of ringer serum by 10 ml/ min intravenous infusion. In both groups, dextrose solution 5% was used as a media for dilatation of the uterine cavity. The amount of bleeding, absorbed volume, the success rate of surgery, resolution of hysteroscopy image, side effects of two drugs, days of hospital stay, all were recorded in a pre-designed checklist. Finally, data collected and analyzed by SPSS 21.Result: In this clinical trial, 92 patients in both groups were matched for age, gravidity, parity and number of intrauterine myomas. Data showed that bleeding in grade 0 (P= 0.000), grade 1(p= 0.003) and grade 2(p=0.00) in first groups was less. The hemoglobin and hematocrit alteration after and before surgery was not different between 2 groups. Hospital stay duration was same in 2 groups. The mean time of hysteroscopic myomectomy was lower in first group. The amount of absorbed volume did not differ between 2 groups. The resolution of image during hysteroscopy in first group was better (p=0.00). The success rate was similar and no side effect of drug was observed. The electrolytes level did not show significant difference.Conclusion: Our results showed that tranexamic acid is safe and has less side effect, which can reduce the amount of bleeding during surgery, duration of surgery, and clarify the resolution in myomectomy with hysteroscopy.

کلیدواژه ها:

Tranexamic acid ، Oxytocin ، Uterine myoma ، Hysteroscopy