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The effects of sequential use of oxytocin and sublingual nitroglycerin in the cases of retained placenta
Authors:Maryam Kashanian  Samira Hasankhani  Narges Sheikhansari  Shohreh Bahasadri  Homa Homam
Affiliation:1. Department of Obstetrics and Gynecology, Akbarabadi Teaching Hospital, Iran University of Medical Sciences, Tehran, Iran and maryamkashanian@yahoo.com;3. Department of Obstetrics and Gynecology, Akbarabadi Teaching Hospital, Iran University of Medical Sciences, Tehran, Iran and;4. Faculty of Medicine, University of Southampton, Southampton, UK
Abstract:Objectives: To evaluate the effects of adding sublingual nitroglycerin to oxytocin, for delivery of retained placenta after vaginal delivery.

Method: The study was performed as a placebo controlled clinical trial on women who did not finish delivering placenta after 30 min of active management of the third stage of labor. In case group, 1 mg nitroglycerin and in the control group, placebo was prescribed sublingually.

Results: In total, 80 women finished the study. The number of manual removal of placenta did not show significant difference between the two groups [25 women (62.5%) in the case and 30 women (75%) in the control group, p?=?0.335]. There was no significant difference between the two groups according to duration of the third stage of labor, hemoglobin index, decline in HB index?>30% and maternal vital signs after treatment. There was no significant difference between the two groups according to adverse effects [eight women (20%) in the case group and four (10%) in the control group (p?=?0.348)].

Conclusion: The sequential use of oxytocin and sublingual nitroglycerin could not lead to delivery of more placentas and did not reduce the necessity of manual removal of placenta in comparison with placebo.
Keywords:Manual removal of placenta  nitroglycerin  oxytocin  pregnancy and delivery  retained placenta  third stage of labor
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