Introduction: Misoprostol, a prostaglandin E1 analog, has been proposed to reduce uterine bleeding due to its contractile effects on the uterine myometrium. The aim of this study was to investigate the effect of sublingual administration of misoprostol in reducing bleeding during abdominal myomectomy.

Materials and Methos receiving 400 micrograms of sublingual misoprostol or placebo, which was administered 30 minutes beforeume of intraoperative bleeding was estimated by collecting blood in the suction and calculating the amount of blood absorbed in the gauze and pads. The decrease in hemoglobin, the need for blood transfusion, and drug side effects were also recorded.

Results: The results showed that the average blood loss in the intervention group was 144 ml less than in the control group (345 ± 128 vs. 489 ± 167 ml; p < 0.001). The decrease in Hb and Hct in the intervention group at 24 hours after surgery was 1.2 ± 0.6 g/dL and 3.5 ± 1.1%, respectively, which was significantly different from the control group (2.1 ± 0.8 g/dL and 5.8 ± 1.6%) (p < 0.001). The duration of surgery in the intervention group was 13 minutes shorter (95 ± 21 vs. 108 ± 28 minutes; p = 0.015) and the length of stay in the hospital was 0.7 days shorter (2.4 ± 0.7 vs. 3.1 ± 0.9 days; p = 0.003).

Conclusion: According to the results obtained, misoprostol can be used as an effective and safe adjunctive method in the management of bleeding during abdominal myomectomy.