Takeaway
- The use of sublingual nitroglycerin does not aid in the management of retained placenta.
Why this matters
- Retained placenta after delivery affects 0.1%-2% deliveries and is associated with postpartum hemorrhage.
Key results
- There were no differences in time to delivery of placenta between the groups (12.1 vs 12.2 minutes; P=.60).
- More women received blood transfusion in the intervention group (11.4% vs 7.8%; P=.03).
- An equal number of women in both groups required manual removal of placenta in the operating room (73.9% of nitroglycerin vs 73% of controls; P=.74).
Study design
- The GOT-IT trial, a randomized, placebo-controlled, double-blind trial between 2014 and 2017 at 29 UK delivery units.
- Women with retained placenta following vaginal delivery were identified and enrolled.
- The intervention group (self-administered 2 puffs of sublingual nitroglycerin [800 μg]; n=543) was compared with a control group (placebo spray; n=564).
- Primary outcome was the need for manual removal of the placenta 15 minutes following intervention.
- Funding: UK National Institute for Health Research Health Technology Assessment Program.
Limitations
- Causes for retained placenta were not identified; different causes of retained placenta would theoretically affect response to nitroglycerin.
References
References