Cochrane · systematic review · CD005355
Interventions to reduce haemorrhage during myomectomy for fibroids
Kongnyuy, EJ, Wiysonge, CS · Cochrane Database of Systematic Reviews · 2014 · Cochrane Library
Gynaecology and FertilityAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
29
current version
GRADE rated
27
No studies
2
Included studies
NR
No studies 2 · 6.9%Ungraded 0 · 0%Very low 2 · 6.9%Low 18 · 62.1%Moderate 7 · 24.1%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Interventions to reduce blood loss during myomectomy for fibroids compared to placebo or no treatment
Population: Women with fibroids
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Intervention Interventions to reduce blood loss during myomectomy for fibroids vs placebo or no treatment | no estimate extracted | NR | No studies |
Misoprostol in abdominal myomectomy Interventions to reduce blood loss during myomectomy for fibroids vs placebo or no treatment | no estimate extracted | 1 study · 25 participants | Moderate |
Misoprostol in laparoscopic myomectomy Interventions to reduce blood loss during myomectomy for fibroids vs placebo or no treatment | no estimate extracted | 1 study · 64 participants | Moderate |
Vasopressin Interventions to reduce blood loss during myomectomy for fibroids vs placebo or no treatment | no estimate extracted | 3 studies · 128 participants | Moderate |
Bupivicaine plus epinephrine Interventions to reduce blood loss during myomectomy for fibroids vs placebo or no treatment | no estimate extracted | 1 study · 60 participants | Low |
Intravenous injection of tranexamic acid Interventions to reduce blood loss during myomectomy for fibroids vs placebo or no treatment | no estimate extracted | 1 study · 100 participants | Low |
Gelatin‐thrombin matrix Interventions to reduce blood loss during myomectomy for fibroids vs placebo or no treatment | no estimate extracted | 1 study · 50 participants | Low |
Ascorbic acid Interventions to reduce blood loss during myomectomy for fibroids vs placebo or no treatment | no estimate extracted | 1 study · 102 participants | Low |
Dinoprostone (prostaglandin E2 analogue) Interventions to reduce blood loss during myomectomy for fibroids vs placebo or no treatment | no estimate extracted | 1 study · 108 participants | Low |
Loop ligation of myoma pseudocapsule plus vasopressin Interventions to reduce blood loss during myomectomy for fibroids vs placebo or no treatment | no estimate extracted | 1 study · 70 participants | Low |
Fibrin sealant patch (collagen sponge with thrombin and fibrinogen) Interventions to reduce blood loss during myomectomy for fibroids vs placebo or no treatment | no estimate extracted | 1 study · 70 participants | Low |
Misoprostol compared to placebo to reduce blood loss during myomectomy for fibroids
Population: Women with fibroids
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Blood loss (ml) Estimated blood loss during myomectomy Misoprostol vs placebo to reduce blood loss during myomectomy | no estimate extracted | 2 studies · 89 participants | Moderate Downgraded: risk of bias |
Need for blood transfusion Number of participants who received blood transfusion Misoprostol vs placebo to reduce blood loss during myomectomy | OR 0.36 [0.05, 2.5] | 2 studies · 89 participants | Low Downgraded: risk of bias |
Duration of surgery (min) Operative time Misoprostol vs placebo to reduce blood loss during myomectomy | MD 9 | 1 study · 25 participants | Low Downgraded: risk of bias |
Vasopressin versus placebo to reduce blood loss during myomectomy for fibroids
Population: Women with fibroids
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Blood loss (ml) Estimated blood loss during myomectomy Vasopressin vs placebo to reduce blood loss during myomectomy | no estimate extracted | 3 studies · 128 participants | Moderate Downgraded: risk of bias |
Need for blood transfusion Participants who received blood transfusion Vasopressin vs placebo to reduce blood loss during myomectomy | OR 0.15 [0.03, 0.74] | 2 studies · 90 participants | Moderate Downgraded: risk of bias |
Duration of surgery Operative time Vasopressin vs placebo to reduce blood loss during myomectomy | no estimate extracted | 2 studies · 108 participants | Moderate Downgraded: risk of bias |
Bupivicaine plus epinephrine compared to placebo to reduce blood loss during myomectomy for fibroids
Population: Women with fibroids
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Blood loss (ml) Estimated blood loss during myomectomy Bupivicaine plus epinephrine vs placebo to reduce blood loss during myomectomy | no estimate extracted | 1 study · 60 participants | Low Downgraded: risk of bias |
Need for blood transfusion Participants who received blood transfusion Bupivicaine plus epinephrine vs placebo to reduce blood loss during myomectomy | no estimate extracted | NR | No studies |
Duration of surgery (min) Operative time Bupivicaine plus epinephrine vs placebo to reduce blood loss during myomectomy | no estimate extracted | 1 study · 60 participants | Low Downgraded: risk of bias |
Peri‐cervical tourniquet compared to no treatment to reduce blood loss during myomectomy for fibroids
Population: Women with fibroids
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Blood loss (ml) Estimated blood loss during myomectomy Peri‐cervical tourniquet vs no treatment to reduce blood loss during myomectomy | no estimate extracted | 2 studies · 121 participants | Low Downgraded: risk of bias |
Need for blood transfusion Participants who received blood transfusion Peri‐cervical tourniquet vs no treatment to reduce blood loss during myomectomy | OR 0.22 [0.09, 0.55] | 2 studies · 121 participants | Low Downgraded: risk of bias |
Duration of surgery (min) Operative time Peri‐cervical tourniquet vs no treatment to reduce blood loss during myomectomy | no estimate extracted | 1 study · 28 participants | Very low Downgraded: risk of bias |
Gelatin‐thrombin matrix compared to placebo or no treatment to reduce blood loss during myomectomy for fibroids
Population: Women with fibroids
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Blood loss (ml) Estimated blood loss during myomectomy Gelatin‐thrombin matrix vs placebo or no treatment to reduce blood loss during myomectomy | no estimate extracted | 1 study · 50 participants | Low Downgraded: risk of bias |
Need for blood transfusion Participants who received blood transfusion Gelatin‐thrombin matrix vs placebo or no treatment to reduce blood loss during myomectomy | OR 0.01 [0, 0.1] | 1 study · 50 participants | Low Downgraded: risk of bias |
Duration of surgery (min) Operative time Gelatin‐thrombin matrix vs placebo or no treatment to reduce blood loss during myomectomy | MD 5 [1.29, 8.71] | 1 study · 50 participants | Low Downgraded: risk of bias |
Ascorbic acid compared to no treatment to reduce blood loss during myomectomy for fibroids
Population: Women with fibroids
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Blood loss (ml) Estimated blood loss during myomectomy Ascorbic acid vs no treatment to reduce blood loss during myomectomy | no estimate extracted | 1 study · 102 participants | Low Downgraded: risk of bias |
Need for blood transfusion Participants who received blood transfusion Ascorbic acid vs no treatment to reduce blood loss during myomectomy | OR 0.38 [0.11, 1.32] | 1 study · 104 participants | Very low Downgraded: risk of bias |
Duration of surgery (min) Operative time Ascorbic acid vs no treatment to reduce blood loss during myomectomy | no estimate extracted | 1 study · 102 participants | Low Downgraded: risk of bias |