Reducing blood loss during open myomectomy with intravenous versus topical tranexamic acid: A double-blinded randomized placebo-controlled trial

Objectives: To assess the effect of Intravenous versus Topical Tranexamic acid in reducing intra-operative and post-operative blood loss in abdominal myomectomy surgeries. Materials and methods: In a randomized double-blind placebo-controlled trial, 105 women undergoing abdominal myomectomy for symptomatic uterine leiomyomas were randomly assigned to three groups: group 1 [35 patients received 110 ml normal saline IV just before skin insion], group 2 [35 patients received 1 g tranexamic acid (2 ampoules of kapron 500 mg 5 ml Amoun company) IV just before skin in scion] and group 3 [35 patients received 2 g topical tranexamic acid (4 ampoules of kapron 500 mg 5 ml) applied on myoma bed after myomectomy]. The primary outcome was intra-operative, postoperative and all blood loss estimation. Results: Both Group II (IV tranexamic acid) and Group III (topical tranexamic acid application) showed great reduction in intra-operative and post-operative blood loss (blood in the intraabdominal drain) compared with Group I (placebo group), (P = .0001, 0.0001, 0.0001, 0.0001), so the overall estimated blood loss in group II and III showed highly reduction compared with group I (P = .0001,.0001). Conclusion: Intravenous and Topical Tranexamic acid application safe and reliable method to help decrease blood loss during and after open myomectomy. (C) 2018 Middle East Fertility Society. Production and hosting by Elsevier B.V.