Archives of Gynecology and Obstetrics

, Volume 299, Issue 1, pp 151–157 | Cite as

Oxytocin infusion reduces bleeding during abdominal myomectomies: a randomized controlled trial

  • Berna Aslan ÇetinEmail author
  • Begüm Aydoğan Mathyk
  • Nadiye Köroğlu
  • Ali Soydar
  • Gökhan Demirayak
  • Tayfur Çift
General Gynecology



To evaluate the effectiveness of oxytocin infusion to reduce intraoperative bleeding during abdominal myomectomies.


This randomized, parallel group, blinded study was conducted between October 2017 and May 2018. Patients undergoing abdominal myomectomies were randomized 1:1 either to the oxytocin group or to the control group (saline). In the oxytocin group, 10 IU oxytocin in 500 ml of saline at a rate of 120 ml/h was given during the course of the operation. The primary outcome of this study was to measure intraoperative blood loss between the study groups. Correlation and multiple regression analysis were performed to illustrate factors associated with intraoperative blood loss during the myomectomy.


The mean intraoperative blood loss during the surgery was 489.20 ± 239.72 ml in the oxytocin group and was 641.40 ± 288.21 ml in the control group. The hemoglobin decline was more evident in the control group than in the oxytocin group. Positive correlations were also observed between the intraoperative blood loss and number of fibroids removed during the surgery, largest fibroid removed and weight of fibroids removed. The use of oxytocin infusion during the myomectomy resulted in a reduction of bleeding in the regression model.


Intravenous oxytocin infusion is a safe and practical method to reduce intraoperative blood loss during the abdominal myomectomy.


Myomectomy Oxytocin Intraoperative blood loss Uterine fibroids 


Authors contribution

BAÇ: project development, manuscript writing, data analysis. BAM: project development, manuscript editing, data analysis. NK: data collection. AS: data collection. GD: methodology. TÇ: investigation.

Compliance with ethical standards

Conflict of interest

The author(s) declare that they have no competing interests.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Zimmermann A, Bernuit D, Gerlinger C, Schaefers M, Geppert K (2012) Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women. BMC Womens Health 12:6. CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Pritts EA, Parker WH, Olive DL (2009) Fibroids and infertility: an updated systematic review of the evidence. Fertil Steril 91(4):1215–1223. CrossRefPubMedGoogle Scholar
  3. 3.
    Casini ML, Rossi F, Agostini R, Unfer V (2006) Effects of the position of fibroids on fertility. Gynecol Endocrinol 22(2):106–109. CrossRefPubMedGoogle Scholar
  4. 4.
    Kongnyuy EJ, Wiysonge CS (2014) Interventions to reduce haemorrhage during myomectomy for fibroids. Cochrane Database Syst Rev 8:CD005355. CrossRefGoogle Scholar
  5. 5.
    Lethaby A, Vollenhoven B, Sowter M (2002) Efficacy of pre-operative gonadotrophin hormone releasing analogues for women with uterine fibroids undergoing hysterectomy or myomectomy: a systematic review. BJOG 109(10):1097–1108CrossRefPubMedGoogle Scholar
  6. 6.
    Fletcher H, Frederick J, Hardie M, Simeon D (1996) A randomized comparison of vasopressin and tourniquet as hemostatic agents during myomectomy. Obstet Gynecol 87(6):1014–1018CrossRefPubMedGoogle Scholar
  7. 7.
    Celik H, Sapmaz E (2003) Use of a single preoperative dose of misoprostol is efficacious for patients who undergo abdominal myomectomy. Fertil Steril 79(5):1207–1210CrossRefPubMedGoogle Scholar
  8. 8.
    Helal AS, Abdel-Hady E-S, Refaie E, El Shamy M, El Fattah RA, AlM Mashaly (2010) Preliminary uterine artery ligation versus pericervical mechanical tourniquet in reducing hemorrhage during abdominal myomectomy. Int J Gynaecol Obstet 108(3):233–235. CrossRefPubMedGoogle Scholar
  9. 9.
    Okin CR, Guido RS, Meyn LA, Ramanathan S (2001) Vasopressin during abdominal hysterectomy: a randomized controlled trial. Obstet Gynecol 97(6):867–872PubMedGoogle Scholar
  10. 10.
    Benassi L, Lopopolo G, Pazzoni F, Ricci L, Kaihura C, Piazza F, Vadora E, Zini C (2000) Chemically assisted dissection of tissues: an interesting support in abdominal myomectomy. J Am Coll Surg 191(1):65–69CrossRefPubMedGoogle Scholar
  11. 11.
    Pourmatroud E, Hormozi L, Hemadi M, Golshahi R (2012) Intravenous ascorbic acid (vitamin C) administration in myomectomy: a prospective, randomized, clinical trial. Arch Gynecol Obstet 285(1):111–115. CrossRefPubMedGoogle Scholar
  12. 12.
    Mukhopadhaya N, De Silva C, Manyonda IT (2008) Conventional myomectomy. Best Pract Res Clin Obstet Gynaecol 22(4):677–705. CrossRefPubMedGoogle Scholar
  13. 13.
    Westhoff G, Cotter AM, Tolosa JE (2013) Prophylactic oxytocin for the third stage of labour to prevent postpartum haemorrhage. Cochrane Database Syst Rev 10:CD001808. CrossRefGoogle Scholar
  14. 14.
    Yamaguchi ET, Cardoso MM, Torres ML, Nascimento RC, Ribeiro MC, Frerichs E, Payen D (2011) Serum oxytocin concentrations in elective caesarean delivery: a randomized comparison of three infusion regimens. Int J Obstet Anesth 20(3):224–228. CrossRefPubMedGoogle Scholar
  15. 15.
    Fuchs AR, Fuchs F, Soloff MS (1985) Oxytocin receptors in nonpregnant human uterus. J Clin Endocrinol Metab 60(1):37–41. CrossRefPubMedGoogle Scholar
  16. 16.
    Wang CJ, Yuen LT, Yen CF, Lee CL, Soong YK (2004) A simplified method to decrease operative blood loss in laparoscopic-assisted vaginal hysterectomy for the large uterus. J Am Assoc Gynecol Laparosc 11(3):370–373CrossRefPubMedGoogle Scholar
  17. 17.
    Agostini A, Ronda I, Franchi F, Bretelle F, Roger V, Cravello L, Blanc B (2005) Oxytocin during myomectomy: a randomized study. Eur J Obstet Gynecol Reprod Biol 118(2):235–238. CrossRefPubMedGoogle Scholar
  18. 18.
    Shokeir T, El-Lakkany N, Sadek E, El-Shamy M, Abu Hashim H (2011) An RCT: use of oxytocin drip during hysteroscopic endometrial resection and its effect on operative blood loss and glycine deficit. J Minim Invasive Gynecol 18(4):489–493. CrossRefPubMedGoogle Scholar
  19. 19.
    Chen CL, Xu YJ, Liu P, Zhu JH, Ma B, Zeng BL, Zhou Y, Wang L, Tang YX, Guo CJ (2013) Characteristics of vascular supply to uterine leiomyoma: an analysis of digital subtraction angiography imaging in 518 cases. Eur Radiol 23(3):774–779. CrossRefPubMedGoogle Scholar
  20. 20.
    Dumousset E, Chabrot P, Rabischong B, Mazet N, Nasser S, Darcha C, Garcier JM, Mage G, Boyer L (2008) Preoperative uterine artery embolization (PUAE) before uterine fibroid myomectomy. Cardiovasc Intervent Radiol 31(3):514–520. CrossRefPubMedGoogle Scholar
  21. 21.
    Alobaid A, Alqadri T, Serat F, Riaz M, Alobaid S, Aldakhil L (2011) The effect of uterine blood supply cutoff during myomectomy. Ann Saudi Med 31(6):598–601. CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Song T, Kim MK, Kim ML, Jung YW, Yun BS, Seong SJ (2015) Use of vasopressin vs epinephrine to reduce haemorrhage during myomectomy: a randomized controlled trial. Eur J Obstet Gynecol Reprod Biol 195:177–181. CrossRefPubMedGoogle Scholar
  23. 23.
    Arrowsmith S, Kendrick A, Wray S (2010) Drugs acting on the pregnant uterus. Obstet Gynaecol Reprod Med 20(8):241–247. CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Dawood MY, Lau M, Khan-Dawood FS (1999) Localization and expression of oxytocin receptor and its messenger ribonucleic acid in peri-implantation phase human endometrium during control and clomiphene-treated cycles. Am J Obstet Gynecol 181(1):50–56CrossRefPubMedGoogle Scholar
  25. 25.
    Weston GC, Cann L, Rogers PA (2003) Myometrial microvascular endothelial cells express oxytocin receptor. BJOG 110(2):149–156CrossRefPubMedGoogle Scholar
  26. 26.
    Lee KH, Khan-Dawood FS, Dawood MY (1998) Oxytocin receptor and its messenger ribonucleic acid in human leiomyoma and myometrium. Am J Obstet Gynecol 179(3 Pt 1):620–627CrossRefPubMedGoogle Scholar
  27. 27.
    Wang CJ, Lee CL, Yuen LT, Kay N, Han CM, Soong YK (2007) Oxytocin infusion in laparoscopic myomectomy may decrease operative blood loss. J Minim Invasive Gynecol 14(2):184–188. CrossRefPubMedGoogle Scholar
  28. 28.
    Atashkhoei S, Fakhari S, Pourfathi H, Bilehjani E, Garabaghi PM, Asiaei A (2017) Effect of oxytocin infusion on reducing the blood loss during abdominal myomectomy: a double-blind randomised controlled trial. BJOG 124(2):292–298. CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and Gynecologyİstanbul Kanuni Sultan Süleyman Training and Research HospitalHalkalı, IstanbulTurkey
  2. 2.Mother Infant Research Institute at Tufts Medical CenterBostonUSA
  3. 3.Obstetrics and Gynecology Departmentİstanbul Sadi Konuk Training and Research HospitalIstanbulTurkey
  4. 4.Obstetrics and Gynecology DepartmentBursa Yüksek Ihtisas Training and Research HospitalBursaTurkey

Personalised recommendations