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Nitroglycerin as a uterine relaxant: a systematic review
Pamela J Morgan1, Rose Kung, Jordan Tarshis
1Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'Obstetrique Et Gynecologie Du Canada : JOGC
|August 28, 2002
Summary
Nitroglycerin effectively reduces pain in primary dysmenorrhea. However, its superiority over other tocolytic agents for preterm labor is unproven, despite some benefits compared to placebo.
Area of Science:
- Obstetrics and Gynecology
- Pharmacology
Background:
- Nitroglycerin is utilized in various obstetric and gynecologic applications.
- Its efficacy as a uterine relaxant requires systematic evaluation.
Purpose of the Study:
- To assess the effectiveness of nitroglycerin in managing preterm labor, aiding fetal extraction during Cesarean sections, facilitating external cephalic version, assisting embryo transfer, enabling cervical dilation for first-trimester abortions, and treating primary dysmenorrhea.
Main Methods:
- A systematic review of randomized controlled trials (RCTs) was conducted.
- Searches included PubMed, Cochrane Controlled Trials Register, and the International Journal of Obstetric Anesthesia up to January 2001.
- Included RCTs compared nitroglycerin to placebo or other interventions, with a quality score of 2 or higher.
Main Results:
- Nitroglycerin was more effective than placebo for arresting preterm labor but not superior to ritodrine or magnesium.
- It showed no advantage over placebo for uterine relaxation during Cesarean sections or external cephalic version.
- Nitroglycerin aided cervical dilation for first-trimester pregnancy termination and significantly decreased pain in primary dysmenorrhea.
- Fewer complications were observed in the nitroglycerin group compared to placebo for preeclampsia, though incidence was not reduced.
Conclusions:
- Nitroglycerin's superiority over current tocolytic agents for preterm labor remains unproven.
- Nitroglycerin is effective in reducing pain associated with primary dysmenorrhea.