Intraoperative Carbetocin to Decrease Blood Loss During Hysteroscopic Myomectomy
Status:
Recruiting
Trial end date:
2022-02-01
Target enrollment:
Participant gender:
Summary
Submucous myomas represent one of the main indications of operative hysteroscopy. Since 1976
when Neuwirth and Amin reported the first five cases of excision of submucous myomas ,
several techniques have been developed in order to render hysteroscopic myomectomy a safe and
effective procedure .
Hysteroscopic myomectomy is currently considered the "gold standard" minimally invasive
approach for the treatment of symptomatic submucous myomas . Patients undergoing
hysteroscopic myomectomy are liable to significant blood loss, and hemodynamic and
hematological disturbances. Excessive bleeding during hysteroscopic myomectomy remains a
major challenge for the endoscopic gynecological surgeons. Many interventions were introduced
to reduce the risk of bleeding during myomectomy. These include the use of utero-tonics such
as oxytocin, or the use of anti-fibrinolytics such as tranexamic acid . The potential
advantage of oxytocin infusion during hysteroscopic myomectomy is that it can maintains
uterine contractility throughout the procedure, and thus, reduce blood loss .
Carbetocin (1-deamino-1-monocarba-(0-2-methyltyrosine)-oxytocin) is a long-acting synthetic
agonist analogue of the human oxytocin. When injected to a woman, it induces uterine
contractions . Although many interventions have been described to reduce the intraoperative
blood loss during hysteroscopic myomectomy, there is a need for a well-designed randomized
controlled trials to identify the most efficient interventions, with reasonable safety
profiles, to help the perform a safe and curative surgery.