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Updated: Jun 2, 2025
Comprehensive Evaluation of the Effectiveness and Safety of Placenta-Targeted Drug Delivery Using Three Complementary Methods
Published on: September 10, 2018
Nitroglycerine for retained placenta: a meta-analysis of randomized controlled trials
Alessandro Petrecca1, Gabriele Saccone2, Vincenzo Berghella3
1Department of Women's, Child and Public Health Sciences, UOC Gynecology Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy (Dr Petrecca).
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:
Four trials, including 1,279 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 (89% vs 90%; RR 0.94, 95% CI 0.74 to 1.20). 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 El resumen está disponible en Español al final del artículo.
