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Obstetrics and Gynecology International
Volume 2012 (2012), Article ID 321207, 6 pages
http://dx.doi.org/10.1155/2012/321207
Clinical Study

Nitroglycerin for Management of Retained Placenta: A Multicenter Study

1Department of Obstetrics and Gynecology, Södra Älvsborg Hospital, 501 82 Borås, Sweden
2Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
3Department of Obstetrics and Gynecology, NÄL Hospital, 461 85 Trollhättan, Sweden
4Department of Obstetrics and Gynecology, Vrinnevi Hospital, 603 79 Norrköping, Sweden
5Department of Obstetrics and Gynecology, Central Hospital of Karlstad, 651 85 Karlstad, Sweden
6Fertility Clinic Sør, Telemark Hospital, 3901 Porsgrunn, Norway

Received 31 January 2012; Revised 21 March 2012; Accepted 22 March 2012

Academic Editor: Russell K. Laros Jr.

Copyright © 2012 Maria Bullarbo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The primary aim was to determine if sequential administration of oxytocin and nitroglycerin is effective for management of retained placenta when performed by obstetricians with no experience of the method. Secondary aims were to examine possible adverse effects of nitroglycerin. One hundred and five women with retained placenta were randomly selected to receive either 1 mg nitroglycerin or placebo tablets sublingually if intravenous oxytocin had failed to expel the placenta. At two of the hospitals some of the midwives were familiar with the use of nitroglycerin. The other midwives and all the participating obstetricians had no clinical experience of the method. In the treatment group, detachment of placenta following nitroglycerin occurred in 37.3% of the women compared to 20.4% in the placebo group ( 𝑃 = 0 . 0 5 6 ). In the two hospitals with some experience of the method, placenta was removed in 9 of 19 (47.4%) women in the nitroglycerin group compared to 3 of 17 (15.0%) women in the placebo group. No adverse effects of clinical importance were registered. Although the difference between the two groups did not reach statistical significance, the higher success rate in the two hospitals with some experience could indicate that clinical experience is of importance in order to achieve placental detachment.