Nitroglycerine for retained placenta: a meta-analysis of randomized controlled trials.

IF 3.8 2区医学 Q1 OBSTETRICS & GYNECOLOGY

American Journal of Obstetrics & Gynecology Mfm Pub Date : 2025-01-14 DOI:10.1016/j.ajogmf.2025.101605

Alessandro Petrecca, Gabriele Saccone, Vincenzo Berghella

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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.

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硝酸甘油用于保留胎盘：随机对照试验的荟萃分析。

目的：评价硝酸甘油对保留胎盘后胎盘娩出的影响设计：荟萃分析的系统评价数据来源：MEDLINE， PROSPERO, Scopus, ClinicalTrials.gov， EMBASE, Sciencedirect, Cochrane Library， Scielo检索自其成立至2024年2月。入选标准：我们纳入了所有比较使用硝酸甘油（即干预组）和安慰剂（即对照组）治疗阴道分娩后遗留胎盘的随机临床试验。资料综合：主要观察指标为人工胎盘摘除率。总结测量结果以相对危险度（RR）或95%可信区间（CI）的平均差值（MD）报告。结果：分析了5项试验，包括1362例妊娠。纳入的随机对照试验质量一般。综合结果显示，与对照组相比，阴道分娩后胎盘保留的妇女给予硝酸甘油与人工移除的发生率相似(87%对89%；RR 0.92, 95% CI 0.75 ~ 1.13)。我们也发现了相似的平均产后出血量，并没有显著差异的发生率下降血红蛋白血红蛋白为15%或30%，需要子宫强直。结论：在阴道分娩后胎盘保留的妇女中使用硝酸甘油并没有减少人工取出胎盘的使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Obstetrics & Gynecology Mfm Medicine-Medicine (all)

CiteScore

7.40

自引率

3.20%

发文量

254

审稿时长

40 days

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.