WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

Aya Ismail Jalil (M.B.Ch.B)*, Taghreed Hammood Hatem (C.A.B.O.G)

ABSTRACT

Background: Hysteroscopic myomectomy is the recommended invasive therapeutic option for submucous fibroid. Successful hysteroscopic myomectomy depends on good visualization; and thus, reduction of intraoperative blood loss. Aim of study: To evaluate the efficacy of intrauterine instillation of tranexamic acid during hysteroscopic myomectomy regarding the reduction of blood loss and improvement of intraoperative view. Patients and methods: This is a randomized case-control study that has been conducted in Baghdad Teaching Hospital/ Medical city, Baghdad. The data was collected from the 1st of January 2023 to the 1st of November 2023. The study enrolled 100 patients (52 Tranexamic group and 48 controls). selected cases were patients who presented to the outpatient clinic of the department of Obstetrics and Gynecology in Baghdad Teaching Hospital due to complaints of either infertility or abnormal uterine bleeding and were diagnosed with uterine myoma (grade 0 or 1). The patients were scheduled for hysteroscopic assessment, which was performed in the operational theatre under general anesthesia. Results: Use of tranexamic acid was significantly associated with reduction of bleeding, improved quality of operative view, reduced volume of distention medium, reduced operative time (27.9 minutes ± 6.7 tranexamic acid group vs. 31.9 minutes ± 8.2 control group, p value = 0.021), and decreased duration of hospital stay (Tranexamic acid group: 7.3 hours ± 3.4 vs. control group: 9.2 hours ± 3.3, p value= 0.018). Conclusion: Local instillation of tranexamic acid during hysteroscopic myomectomy is an effective way to reduce blood loss, which improves the surgeons operative view. Improving the operative view has major implications regarding reduction of operative time, hospital stay, and intraoperative complications.