Vaginal Misoprostol Versus Bilateral Uterine Artery Ligation in Decreasing Blood Loss in Trans-abdominal Myomectomy

Inclusion Criteria

• •women in the reproductive age (20-40 years) diagnosed as having uterine fibroids who are consenting to have trans- abdominal myomectomy in the postmenstrual period diagnosed by: clinical symptoms and signs:
• •abnormal uterine bleeding (menorrhagia or/and metrorrhagia)
• •pain (dull aching lower abdominal pain or dysmenorrhea)
• •pressure symptoms (dyspareunia, dysuria, dyschezia or /and backache)
• •progressive abdominal enlargement (abdominal swelling) ultrasound (abdominal or transvaginal) to confirm the clinical diagnosis:
• •maximum diameter of the largest fibroid is greater than 4 cm
• •maximum number of uterine myomas is not to be more than 5 myomas
• •uterine fibroid may be subserous or intramural