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The following is a summary of “Effect of intramyometrial injection of terlipressin versus carbetocin on hemoglobin and blood loss during open myomectomy operations without using haemostatic tourniquets: Double blinded randomized placebo-controlled trial,” published in the March 2025 issue of European Journal of Obstetrics and Gynecology and Reproductive Biology by Elbanna et al. 

Uterine fibroids, common in reproductive-age women, pose surgical challenges due to significant intraoperative blood loss during myomectomy.  

Researchers conducted a retrospective study to assess the effectiveness of intramyometrial terlipressin and carbetocin in reducing intraoperative bleeding and maintaining hemoglobin levels.  

They carried out a randomized, double-blind, placebo-controlled trial between February 2022 and April 2024 at El-Resala and Al-Aseema hospitals under the supervision of the National Research Center.  

The results showed that 99 of 119 eligible female individuals participated in the study, while 13 did not meet the inclusion criteria. Participants were divided equally into 3 groups (n = 33): terlipressin group (A), carbetocin group (B), and saline group (C). Blood loss significantly varied among groups (P < 0.001), with lower mean values in the terlipressin group compared to the carbetocin group (321 mL vs 418 mL). Both groups exhibited significantly reduced blood loss compared to the saline group (mean = 969 mL). The terlipressin group had a significantly lower need for blood transfusion than the saline group (P < 0.05). No significant differences were observed in operative time or side effects among the 3 groups (P < 0.05).  

Investigators concluded that terlipressin reduced blood loss during myomectomy compared to carbetocin, recommending its adoption for improved outcomes. 

Source: ejog.org/article/S0301-2115(25)00179-4/abstract