Department of Obstetrics and Gynecology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
Medicina (Kaunas). 2021 May 12;57(5):478. doi: 10.3390/medicina57050478.
The PROPESS, a controlled-release dinoprostone vaginal delivery system, is a pharmacological cervical ripening intervention and promotes cervical change causing uterine contraction. During insertion of the PROPESS, uterine hyperstimulation could occur and result in fetal heart rate (FHR) abnormality. We report a case of uterine hyperstimulation accompanied with FHR abnormality caused by the PROPESS in a pregnant woman. Postural change, oxygenation, fluid infusion, and the immediate PROPESS removal were ineffective to address the adverse event, so we administered nitroglycerin for acute uterine relaxation. The nitroglycerin resulted in uterine relaxation, and the FHR abnormality was resolved immediately, thereby preventing an emergency cesarean section. Therefore, nitroglycerin could be considered an effective option for uterine hyperstimulation accompanied with FHR abnormality caused by the PROPESS.
PROPESS（一种控释地诺前列酮阴道分娩系统）是一种药理学宫颈成熟干预措施，可促进宫颈变化引起子宫收缩。在插入 PROPESS 时，可能会发生子宫过度刺激，导致胎儿心率（FHR）异常。我们报告了一例由 PROPESS 引起的子宫过度刺激伴 FHR 异常的病例。体位改变、氧合、补液和立即取出 PROPESS 对处理不良事件均无效，因此我们给予硝酸甘油以实现子宫的急性松弛。硝酸甘油导致子宫松弛，FHR 异常立即得到解决，从而避免了紧急剖宫产。因此，硝酸甘油可被视为 PROPESS 引起的子宫过度刺激伴 FHR 异常的有效选择。
