carbetocin and Uterine-Neoplasms

To evaluate the efficacy of carbetocin versus placebo in decreasing intraoperative blood loss and the need for blood transfusion during abdominal myomectomy.. Randomized, double-blind, placebo-controlled trial.. Tertiary university hospital from September 2019 to February 2020.. A total of 138 women with symptomatic leiomyoma who were candidates for abdominal myomectomy (n = 69 in each group).. We randomized the study participants in a 1:1 ratio to carbetocin and placebo groups. Intravenous 100 μg carbetocin or placebo was administered slowly after induction of anesthesia.. Intraoperative blood loss, need for blood transfusion, postoperative hemoglobin, operative time, length of hospitalization, and drug side-effects.. The baseline characteristics were similar among all groups. Carbetocin had significantly lower intraoperative blood loss compared with placebo (mean difference 184 mL). Hemoglobin level 24 hours after surgery was significantly lower in the placebo group than in the carbetocin group (9.1 ± 0.8 vs. 10.3 ± 0.6 g/dL). Eight women in the carbetocin group needed blood transfusion compared with 17 in placebo group. Operative time, length of hospitalization, and side-effects were similar in both groups.. A single preoperative intravenous dose of 100 μg carbetocin is a simple, practical, and effective method of decreasing intraoperative blood loss and the need for blood transfusion during abdominal myomectomy, with tolerable, few, nonsignificant side-effects.. NCT04083625.

Topics: Adult; Blood Loss, Surgical; Delayed-Action Preparations; Double-Blind Method; Female; Humans; Leiomyoma; Middle Aged; Oxytocics; Oxytocin; Prospective Studies; Treatment Outcome; Uterine Myomectomy; Uterine Neoplasms

We report the case of a pregnancy of 16 weeks with anemia and a presumptive diagnosis of partial mole. In secondary care this diagnosis was ruled out through ultrasonography and diffuse cysts were found in the myometrium. Spectral Doppler ultrasound showed no flow, but it could be observed with power angiography. Cesarean section was performed at 38 weeks and hysterectomy 24 hours after because of intra-abdominal hemorrhage. Power angiography, spectral Doppler and serum human chorionic gonadotropin are the most useful diagnostic tools in the differential diagnosis of diffuse cavernous hemangioma of the uterus. Postpartum hemorrhage is a likely complication.

Topics: Blood Transfusion; Cesarean Section; Combined Modality Therapy; Diagnosis, Differential; Female; Hemangioma, Cavernous; Hemoperitoneum; Humans; Hydatidiform Mole; Hysterectomy; Infant, Newborn; Male; Oxytocics; Oxytocin; Postpartum Hemorrhage; Pregnancy; Pregnancy Complications, Neoplastic; Ultrasonography; Uterine Neoplasms; Young Adult