Rodgers Blake Conley, Pasternak Adam, Gray Richard
Department of Family Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.
BMJ Case Rep. 2013 Sep 6;2013:bcr2013010505. doi: 10.1136/bcr-2013-010505.
A 34-year-old gravida 2, para 1 woman delivered a viable male infant and developed retained placenta due to entrapment. A nitroglycerin tablet was used to relax the lower uterine segment and cervix, which allowed the placenta to pass through the cervix for delivery. The nitroglycerin tablet was placed in the cervix and held in place by the delivering physician as it dissolved. Soon after administration, the intact placenta delivered. The patient did not experience the typical side effects of headache, asymptomatic decrease in blood pressure, hypotension, palpitations or dizziness that can be associated with administration of nitroglycerin. We suspect that this novel localised route of nitroglycerin administration may be an effective management strategy to treat trapped placenta while minimising side effects. However, the outcomes of this treatment would require further study.
一名34岁、孕2产1的女性分娩出一名存活男婴，因胎盘嵌顿出现胎盘滞留。使用一片硝酸甘油来松弛子宫下段和宫颈，使胎盘得以通过宫颈娩出。硝酸甘油片被放置在宫颈内，在溶解过程中由接生医生固定在位。给药后不久，完整的胎盘娩出。患者未出现与硝酸甘油给药相关的典型副作用，如头痛、无症状性血压下降、低血压、心悸或头晕。我们怀疑这种新型的硝酸甘油局部给药途径可能是治疗胎盘嵌顿同时将副作用降至最低的有效管理策略。然而，这种治疗的效果还需要进一步研究。
