Intravenous nitroglycerin for controlled cord traction in the management of retained placenta.

Abstract

OBJECTIVE:

To determine the effect of 200 μg of intravenous nitroglycerin in the release of retained placenta by controlled cord traction.

METHODS:

In this randomized controlled study, 40 women with a placenta retained for 30 minutes received intravenously 200 μg of nitroglycerin or a normal saline solution before umbilical cord traction was initiated. The rates of successful removal of the retained placenta in the study (n=20) and control (n=20) groups were compared, as were blood pressure, pulse rate, blood loss, and adverse effects.

RESULTS:

The placenta was released in only 15% and 20% of the participants in the study and control group, respectively. The remainder of the participants required general anesthesia and manual removal of the retained placenta regardless of group assignation. Blood pressure fell in significantly more women in the study group, but there were no differences in estimated blood loss or minor adverse effects.

CONCLUSION:

Intravenously administered nitroglycerin did not facilitate the release of retained placenta by umbilical cord traction. However, cord traction may be performed longer than 30 minutes to attempt releasing the placenta before operative manual removal is initiated.

• Authors: Shusee Visalyaputra, Japarath Prechapanich, Sukanya Suwanvichai, Suwimol Yimyam, Ladda Permpolprasert, Pattipa Suksopee
• Journal: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (Int J Gynaecol Obstet) Vol. 112 Issue 2 Pg. 103-6 (Feb 2011) ISSN: 1879-3479 [Electronic] United States
• PMID: 21144515 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Vasodilator Agents
• Nitroglycerin

Topics

• Adult
• Blood Pressure (drug effects)
• Female
• Heart Rate (drug effects)
• Humans
• Injections, Intravenous
• Nitroglycerin (administration & dosage, adverse effects, therapeutic use)
• Placenta, Retained (drug therapy)
• Postpartum Hemorrhage (etiology)
• Pregnancy
• Time Factors
• Umbilical Cord
• Vasodilator Agents (administration & dosage, adverse effects, therapeutic use)
• Young Adult