Tranexamic Acid versus Carbetocin for Reduction of Blood Loss during Abdominal Myomectomy: A Randomized Clinical Trial

Introduction: Uterine fibroids are benign tumours of the uterus. They represent the most common benign tumour of the female genital tract during reproductive period. The aim of this study was to decrease blood loss during myomectomy using carbetocin in comparison with tranexamic acid.

Material and Methods: In this randomized clinical trial, 132 patients with uterine fibroids were enrolled for our study at Gynaecology outpatient clinic, Suez Canal University Hospitals, from May 2016 to May 2018. Patients were assessed by full history, clinical examination, transvaginal ultrasound and laboratory investigations. After patients’ counselling and consent, they were randomly assigned into 2 groups (66 patients each); the first group received 30 ml of sodium chloride with added 50mg tranexamic acid, while the second group received 30 ml of sodium chloride with added 100 mg Carbetocin. Both drugs were delivered at the time of skin incision by intravenous infusion. The amount of blood loss was estimated intra-operatively and post-operatively and the collected data were statistically analysed.

Results: Total blood loss was significantly lower in the carbetocin group (399.27 ± 28.94ml) than the tranexamic acid group (535.15 ± 80.30ml) (p <0.001). Intra-operative blood loss was significantly lower in the carbetocin group (371.39 ± 27.54 ml) than the tranexamic acid group (478.48 ± 60.4ml) (p <0.001). Post-operative blood loss was significantly lower in the carbetocin group (27.88 ± 32.32 ml) than the tranexamic acid group (56.67 ± 53.13ml) (p 0.001).

Conclusion: Carbetocin is more effective than tranexamic acid on reduction of blood loss during abdominal myomectomy.

Keywords: Fibroids; Myomectomy; Blood loss; Tranexamic acid; Carbetocin