Opoku-Anane J, Vargas MV, Marfori CQ, et al. - Researchers examined if and how perioperative bleeding and blood transfusion requirements in women undergoing a myomectomy are influenced by the early administration of intravenous tranexamic acid. In this double-blinded randomized placebo controlled trial, sixty women with symptomatic fibroids who were thought to be at risk for large intraoperative blood loss were randomized to receive a single intravenous bolus injection of tranexamic 15 mg/kg (intervention group) vs an intravenous bolus injection of saline of equivalent volume (placebo group) 20 minutes prior to initial surgical incision. Risk for large intraoperative blood loss was assessed using the following criteria: 1) at least one fibroid greater than or equal to 10 cm, 2) any intramural or broad ligament fibroid greater than or equal to 6 cm, or 3) at least 5 total fibroids based on preoperative imaging. Outcomes revealed no decreased blood loss in correlation with intravenous administration of tranexamic acid in patients undergoing mostly laparoscopic or robotic myomectomies.