Design: Case report

Setting: Operating room. Patient was placed under general anesthesia and placed in high lithotomy position with her legs in Yellofins stirrups. Arms were tucked at her side will all pressure points padded. The patient's abdomen, perineum, and vagina were prepped and draped in normal sterile fashion.

Patients or Participants: Single patient. G0P0 presenting for management of symptomatic fibroids.

Interventions: Preoperative misoprostol and tranexamic acid, temporary uterine artery and ovarian vessel clamps ,and dilute vasopressin at the time of myomectomy.

Measurements and Main Results: Estimated blood loss was 120 ml. On postoperative hysteroscopy normal endometrial cavity with no masses. Patent cervical canal with no adhesions or defects noted.

Conclusion: Adequate surgical planning and preemptive hemostatic measures may aid in blood loss reduction improving patient outcomes.