Comparison of Intraoperative Mean Blood Loss Between Uterine Artery Tourniquet and Vaginal Misoprostol in Cases Undergoing Transabdominal Myomectomy

Objective: To compare the mean intraoperative blood loss between intraoperative uterine artery tourniquetand preoperative vaginal misoprostol during transabdominal myomectomy.Material and Methods: This quasi-experimental comparative study was conducted at Lahore GeneralHospital between March 30 and September 29, 2024. A total of 54 patients with symptomatic uterine fibroidsundergoing elective transabdominal myomectomy were enrolled and non-randomly allocated into two equalgroups (n=27 each). Group A underwent intraoperative uterine artery tourniquet application, while Group Breceived 400 mcg of vaginal misoprostol one hour before surgery. Data on intraoperative blood loss, alongwith demographic and clinical characteristics, were recorded. SPSS version 26 was used for analysis, and a pvalue≤ 0.05 was considered statistically significant.Results: The mean intraoperative blood loss was significantly lower in the tourniquet group (392.91±84.63mL) compared to the misoprostol group (467.13±107.65 mL;p=0.007). Subgroup analysis showedsignificant benefit of tourniquet use in non-obese patients, younger age group (25–35 years), larger myomas(10–12 cm), longer surgeries, and subserosal fibroid types.Conclusion: The application of a uterine artery tourniquet during transabdominal myomectomy results insignificantly less intraoperative blood loss compared to preoperative vaginal misoprostol. This techniquemay be considered the more favorable option, especially in patients at greater risk of surgical bleeding.Keywords: Uterine fibroids, myomectomy, blood loss, uterine artery tourniquet, vaginal misoprostol,hemostasis, randomized trial.How to cite: Kausar M, Tariq S, Khanum Z, Tahseen H. Comparison of Intraoperative Mean Blood Loss BetweenUterine Artery Tourniquet and Vaginal Misoprostol in Cases Undergoing Transabdominal Myomectomy. Esculapio -JSIMS 2026-5;22(01):88-93.DOI: 10.51273/esculap.v22i01.1473