{"title":"Nitroglycerine for retained placenta: a meta-analysis of randomized controlled trials.","authors":"Alessandro Petrecca, Gabriele Saccone, Vincenzo Berghella","doi":"10.1016/j.ajogmf.2025.101605","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of nitroglycerine on placenta delivery after retained placenta DESIGN: Systematic review with meta-analysis DATA SOURCES: MEDLINE, PROSPERO, Scopus, ClinicalTrials.gov, EMBASE, Sciencedirect, the Cochrane Library, Scielo were searched from their inception until February 2024.</p><p><strong>Eligibility criteria for selecting studies: </strong>We included all randomized clinical trials comparing use of nitroglycerine (i.e. intervention group) with placebo or with no treatment (i.e. control group) given for retained placenta after vaginal delivery.</p><p><strong>Data synthesis: </strong>The primary outcome was rate of manual removal of the placenta. The summary measures were reported as relative risk (RR) or as mean difference (MD) with 95% of confidence interval (CI).</p><p><strong>Results: </strong>Five trials, including 1,362 pregnancies, were analyzed. The quality of the RCTs included was moderate. Pooled results showed that administration of nitroglycerine in women with retained placenta after vaginal delivery was associated with similar incidence of manual removal compared to control (87% vs 89%; RR 0.92, 95% CI 0.75 to 1.13). We also found similar mean postpartum blood loss, and no significant differences in the incidence of drop of hb > 15 or 30%, need for uterotonics.</p><p><strong>Conclusions: </strong>Use of nitroglycerine in women with retained placenta after vaginal delivery did not reduce the use of manual removal of the placenta.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101605"},"PeriodicalIF":3.8000,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Obstetrics & Gynecology Mfm","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ajogmf.2025.101605","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To evaluate the effect of nitroglycerine on placenta delivery after retained placenta DESIGN: Systematic review with meta-analysis DATA SOURCES: MEDLINE, PROSPERO, Scopus, ClinicalTrials.gov, EMBASE, Sciencedirect, the Cochrane Library, Scielo were searched from their inception until February 2024.
Eligibility criteria for selecting studies: We included all randomized clinical trials comparing use of nitroglycerine (i.e. intervention group) with placebo or with no treatment (i.e. control group) given for retained placenta after vaginal delivery.
Data synthesis: The primary outcome was rate of manual removal of the placenta. The summary measures were reported as relative risk (RR) or as mean difference (MD) with 95% of confidence interval (CI).
Results: Five trials, including 1,362 pregnancies, were analyzed. The quality of the RCTs included was moderate. Pooled results showed that administration of nitroglycerine in women with retained placenta after vaginal delivery was associated with similar incidence of manual removal compared to control (87% vs 89%; RR 0.92, 95% CI 0.75 to 1.13). We also found similar mean postpartum blood loss, and no significant differences in the incidence of drop of hb > 15 or 30%, need for uterotonics.
Conclusions: Use of nitroglycerine in women with retained placenta after vaginal delivery did not reduce the use of manual removal of the placenta.
期刊介绍：
The American Journal of Obstetrics and Gynecology (AJOG) is a highly esteemed publication with two companion titles. One of these is the American Journal of Obstetrics and Gynecology Maternal-Fetal Medicine (AJOG MFM), which is dedicated to the latest research in the field of maternal-fetal medicine, specifically concerning high-risk pregnancies. The journal encompasses a wide range of topics, including:
Maternal Complications: It addresses significant studies that have the potential to change clinical practice regarding complications faced by pregnant women.
Fetal Complications: The journal covers prenatal diagnosis, ultrasound, and genetic issues related to the fetus, providing insights into the management and care of fetal health.
Prenatal Care: It discusses the best practices in prenatal care to ensure the health and well-being of both the mother and the unborn child.
Intrapartum Care: It provides guidance on the care provided during the childbirth process, which is critical for the safety of both mother and baby.
Postpartum Issues: The journal also tackles issues that arise after childbirth, focusing on the postpartum period and its implications for maternal health. AJOG MFM serves as a reliable forum for peer-reviewed research, with a preference for randomized trials and meta-analyses. The goal is to equip researchers and clinicians with the most current information and evidence-based strategies to effectively manage high-risk pregnancies and to provide the best possible care for mothers and their unborn children.
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