Intravenous nitroglycerin for rapid uterine relaxation

Abstract

Nitroglycerin administered intravenously seems to be a rapid and effective uterine muscle relaxant agent without overt adverse effects on mother or fetus.

Sublingual nitroglycerin seems to be effective in the management of retained placenta

“…They also observed that in many cases the entire placenta was expelled following the injection of nitroglycerin. The observation that intravenous nitroglycerin facilitates manual extraction of retained placenta has been confirmed by others (7, 8), 13–15.…”

“…In the present study, oxytocin was routinely administered intravenously following successful placental separation to minimise blood loss. Based on in vitro studies, oxytocin seems to be an effective inhibitor of nitroglycerin‐induced myometrial relaxation (7). However, nitroglycerin should not be given in cases of postpartum hemorrhage or hypovolemia.…”

“…An alternative method for the successful delivery of retained placenta could be sequential administration of oxytocin and nitroglycerin in combination with controlled cord traction 6–8. However, to date, this approach has only been examined in a limited number of patients.…”

Intravenous Nitroglycerin in the Management of Retained Placenta

“…Numerous reports using low-dose NTG for emergent uterus relaxation have been made, and its use in RP has been demonstrated to be safe and effective [18,26,27]. In a survey, NTG was the most commonly used drug for intraoperative emergent situations that needed uterus relaxation.…”

Uterine relaxation during caesarean section under regional anaesthesia: a survey of UK obstetric anaesthetists

“…Intrave-nous GTN has been shown to be safe when used to relax the uterus during caesarean section. 4,5 The effects on the baby appear minimal, levels in umbilical plasma are in the sub-therapeutic range and it does not appear hazardous to neonates. 6 The administration of sublingual GTN has been shown to provide clinically determined uterine relaxation and can be used safely with minimal side effects.…”