Background: Uterine fibroids are common benign female neoplasms which are frequently managed by myomectomy to preserve fertility. It is a bloody procedure due its rich blood supply. The application of uterotonics, like oxytocin, has been recommended to decrease blood loss. Carbetocin is a synthetic analogue of oxytocin, that has a more rapid onset and prolonged action. This study was conducted to evaluate the effect of carbetocin as an utero-tonic agent on reducing blood loss during hysteroscopic myomectomy.

Patients and methods: We included 40 women with submucous myomas and scheduled for hysteroscopic myomectomy in this prospective randomized trial. They were randomly assigned into two groups; Group A received IV carbetocin (1 ml), and Group B (placebo). Intraoperative bleeding was classified as mild, moderate, and severe, whereas the quality of operative field was classified as good, fair, or poor.

Results: Both patient and disease criteria were statistically comparable between the two study groups. However, operative time was significantly prolonged in Group B (33.2 vs. 30.35 minutes in the other group – p = 0.044). The amount of intraoperative bleeding was significantly increased in the same group (p = 0.038). Although preoperative hemoglobin and hematocrit values were comparable between the two groups, both parameters showed a significant decline in the placebo group. Both the quality of operative field and surgeon satisfaction were significantly improved with carbetocin administration.

Conclusion: Carbetocin administration is recommended during hysteroscopic myomectomy to decrease blood loss and improve surgeon satisfaction.