Role of Tranexamic Acid in Reducing Blood Loss During Abdominal Myomectomy

Background: Leiomyoma is benign, monoclonal tumor of the smooth muscle cells of the myometrium. This study aimed to reducing blood loss during myomectomy using either intravenousor topical method. Methods: This study was randomized controlled trials included 60 women undergoing abdominal myomectomy for symptomatic uterine leiomyomas in Department of Obstetrics and Gynecology, at Zagazig University Hospital during the period study year October 2019 to April 2020. Study inclusion criteria were women who attended the outpatient gynecology clinic, seeking treatment for symptomatic leiomyomas and scheduled to undergo abdominal myomectomy with myoma staging from (3 to 6) according to FIGO staging. The primary outcome was intra-operative, postoperative and all blood loss estimation. Results: There was statistically significant difference between the studied groups regarding blood loss with higher blood loss either intraoperative, postoperative and overall blood loss on control than topical than intra venous tranxamic acid group (p-value= 0.8, 0.9 and 0.9) respectively. Regarding need for blood transfusion where (50.0%) of the control group needed blood transfusion while only (10.0%) of intravenous and topicaltranexamic acid groups needed blood transfusion (pvalue= 0.003*). Conclusions: Intravenous and topical tranexamic acid safe and reliable method to help decrease blood loss during open myomectomy without serious side effects.