Treatment protocol
We examined all eligible patients, took full clinical history, and ordered investigations like complete blood count and ultrasound. Then, the baseline data were collected including age, body mass index, baseline HB and HCT, previous cesarean section (CS), parity, and indications for CS. Patients were separated into three simultaneous groups using simple randomization produced by a computer program. Their assignments were made using sealed opaque envelops.All patients underwent the operation by whether the Pfannenstiel or midline vertical incisions. During myomectomy, the patients received whether an injection of 30 IU of oxytocin in 500 ml of normal saline administrated during myomectomy with two ampules of distilled water which had the same color and shape of Ethamsylate and tranexamic acid before skin incision IV (group 1); received injections of 1 g of TA, 250 mg of Ethamsylate, and 110 ml of normal saline IV with an ampule of distilled water infused in 500 ml normal saline which had the same shape and color of oxytocin during myomectomy; (group 2); or received an injection of 110 ml of normal saline IV just before surgical incision with two ampules of distilled water infused in 500 ml normal saline which had the same shape and color of oxytocin; (group 3). All patients, care givers and providers and outcome assessors were blinded.