Effects of hypoxia on cells of the human uterus: Implications for the use of Tourniquets during myomectomy

Objective: Tourniquets are used during myomectomy to minimize blood loss. However, the effect of the resultant uterine hypoxia is uncertain. This study was designed to evaluate the in vitro effects of hypoxia on human uterine cell types, including myometrial, endometrial, and neural cells. Methods: Primary cultures of human myometrial cells and immortalized cultures of human endometrial carcinoma and neuroblastoma cell lines were placed in 100% nitrogen to create cellular hypoxia, in either glucose-containing or glucose-free media. At hourly intervals, cell survival was determined by trypan blue exclusion. Results: Hypoxia decreased cell survival after 2 hours for all three cell types. The rate of cell death was greater for glucose- deprived cells. Conclusions: The cell types found in the human uterus are relatively resistant to the adverse effects of hypoxia. The decreased survival in glucose-free media suggests that anaerobic metabolism may be the basis of this resistance. Based on this study, we recommend that the uterus should be perfused every 1 to 2 hours if tourniquets are used during myomectomy.

Duke Scholars

Author William Ward Hurd Obstetrics and Gynecology, Reproductive Endocrinology & Infe ...