{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:58:01Z","timestamp":1791939481138,"version":"4.3.4"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T00:00:00Z","timestamp":1705536000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["International Journal of Reproductive Medicine"],"published-print":{"date-parts":[[2024,1,18]]},"abstract":"<jats:p>Background. Myomectomy can be associated with life-threatening conditions such as bleeding. Excessive bleeding usually necessitates blood transfusion. Interventions to reduce bleeding during myomectomy will help reduce the need for blood transfusion with its associated complications. Tranexamic acid has been used to reduce bleeding in other surgical procedures, and its usage during myomectomy merits evaluation. Objective. To assess the efficacy of tranexamic acid in reducing myomectomy-associated blood loss. Materials and Methods. This is a prospective double-blinded randomized trial conducted on women who had abdominal myomectomy. Patients were randomized into two groups. The study group received perioperative intravenous tranexamic acid (TXA) while the control group received a placebo. Intraoperative blood loss was calculated by measuring the volume in the suction apparatus and weighing the surgical swabs. In addition, blood collected postoperatively from the wound drains and drapes were measured. Haemoglobin concentrations were determined preoperatively and on second postoperative day for all cases. Any adverse effect was noted in both groups. The data was processed using Epi Info software (7.2.1, CDC, Atlanta, Georgia). The relationships between categorical data were analyzed using <jats:inline-formula><a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><a:msup><a:mrow><a:mi>X<\/a:mi><\/a:mrow><a:mrow><a:mn>2<\/a:mn><\/a:mrow><\/a:msup><\/a:math><\/jats:inline-formula> and Student\u2019s <jats:inline-formula><c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><c:mi>t<\/c:mi><\/c:math><\/jats:inline-formula>-test to determine relationships between continuous variables, with a <jats:inline-formula><e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><e:mi>P<\/e:mi><\/e:math><\/jats:inline-formula> value of 0.05 considered statistically significant, and correlation coefficients were calculated using Pearson\u2019s formula, and probability of 0.05 was set for statistical significance. Results. Symptomatic uterine myomas constituted 17.3% of all gynaecological admissions and 21.3% of gynaecological operations at Federal Teaching Hospital Abakaliki. The mean intraoperative blood loss among patients that had perioperative tranexamic acid infusion was <jats:inline-formula><g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><g:mn>413.6<\/g:mn><g:mo>\u00b1<\/g:mo><g:mn>165.6<\/g:mn><\/g:math><\/jats:inline-formula>\u2009ml, while that of patients with placebo infusion was <jats:inline-formula><i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><i:mn>713.6<\/i:mn><i:mo>\u00b1<\/i:mo><i:mn>236.3<\/i:mn><\/i:math><\/jats:inline-formula>\u2009ml. Perioperative tranexamic acid infusion therefore reduced mean intraoperative blood loss by 300\u2009ml, and this was statistically significant (<jats:inline-formula><k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\"><k:mtext>SMD<\/k:mtext><k:mo>=<\/k:mo><k:mo>\u2212<\/k:mo><k:mn>0.212<\/k:mn><\/k:math><\/jats:inline-formula>, 95% CI: \u2212403.932 to \u2212196.067, <jats:inline-formula><m:math xmlns:m=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\"><m:mi>P<\/m:mi><m:mo>&lt;<\/m:mo><m:mn>0.0001<\/m:mn><\/m:math><\/jats:inline-formula>). Perioperative tranexamic acid reduced mean total blood loss by a value of 532.3\u2009ml, and this is statistically significant (<jats:inline-formula><o:math xmlns:o=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\"><o:mtext>SMD<\/o:mtext><o:mo>=<\/o:mo><o:mn>30.622<\/o:mn><\/o:math><\/jats:inline-formula>, 95% CI: 393.308 to 670.624, <jats:inline-formula><q:math xmlns:q=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M9\"><q:mi>P<\/q:mi><q:mo>&lt;<\/q:mo><q:mn>0.0001<\/q:mn><\/q:math><\/jats:inline-formula>). Tranexamic acid also improved postoperative haemoglobin concentration by 1.8\u2009g\/dl compared with placebo, and this is statistically significant (<jats:inline-formula><s:math xmlns:s=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M10\"><s:mtext>SMD<\/s:mtext><s:mo>=<\/s:mo><s:mo>\u2212<\/s:mo><s:mn>0.122<\/s:mn><\/s:math><\/jats:inline-formula>, 95% CI: 1.182 to 2.473, <jats:inline-formula><u:math xmlns:u=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M11\"><u:mi>P<\/u:mi><u:mo>&lt;<\/u:mo><u:mn>0.0001<\/u:mn><\/u:math><\/jats:inline-formula>). Tranexamic acid infusion decreased hospital stay by about 2 days, and this difference was statistically significant (<jats:inline-formula><w:math xmlns:w=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M12\"><w:mtext>SMD<\/w:mtext><w:mo>=<\/w:mo><w:mo>\u2212<\/w:mo><w:mn>3.929<\/w:mn><\/w:math><\/jats:inline-formula>, 95% CI: -3.018 to \u20130.983, <jats:inline-formula><y:math xmlns:y=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M13\"><y:mi>P<\/y:mi><y:mo>=<\/y:mo><y:mn>0.0003<\/y:mn><\/y:math><\/jats:inline-formula>). There was no adverse drug reaction in the course of the study. Conclusion. The use of tranexamic acid during myomectomy reduced intraoperative and postoperative blood loss. It is also associated with decreased hospital stay. This trial is registered with NCT04560465.<\/jats:p>","DOI":"10.1155\/2024\/2794052","type":"journal-article","created":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T18:20:07Z","timestamp":1705602007000},"page":"1-8","source":"Crossref","is-referenced-by-count":6,"title":["Efficacy of Tranexamic Acid in Reducing Myomectomy-Associated Blood Loss among Patients with Uterine Myomas at Federal Teaching Hospital Abakaliki: A Randomized Control Trial"],"prefix":"10.1155","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2346-8282","authenticated-orcid":true,"given":"Ayodele Adegbite","family":"Olaleye","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8672-8267","authenticated-orcid":true,"given":"Joshua Adeniyi","family":"Adebayo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4695-071X","authenticated-orcid":true,"given":"Justus Ndulue","family":"Eze","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4945-667X","authenticated-orcid":true,"given":"Leonard Ogbonna","family":"Ajah","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3730-621X","authenticated-orcid":true,"given":"Chidebe Christian","family":"Anikwe","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5470-755X","authenticated-orcid":true,"given":"John O.","family":"Egede","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1745-6887","authenticated-orcid":true,"given":"Chidi Ikenna","family":"Ebere","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","first-page":"717","article-title":"Benign disease of the uterus","volume-title":"Dewhurtst\u2019s Textbook of obstetrics and gynecology for postgraduates","author":"A. 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