January/February 2000, Volume 20, Issue 1, Pages 27 - 33

Original Article

Nitroglycerin for Rapid Tocolysis: Development of a Protocol and a Literature Review John Patrick O’Grady, MD, Robert K. Parker, DO & Sejal S. Patel, BA Departments of Obstetrics and Gynecology (J. P. O., S. S. P.) and Anesthesiology (R. K. P.), Tufts University School of Medicine, Baystate Medical Center, Springfield, MA.     Correspondence to: John Patrick O’Grady, MD, Baystate Medical Center, Department of Obstetrics and Gynecology, S-1648, 759 Chestnut Street, Springfield, MA 01199. E-mail: address: patrick.ogrady@bhs.org.

Abstract

OBJECTIVE: A protocol for nitroglycerin (NTG) use based on experiences with regard to new and previously described obstetric cases is presented. The efficacy of NTG tocolysis for obstetric emergencies is clinically evaluated. STUDY DESIGN: Hemodynamically stable parturients requiring acute tocolysis were treated with intravenous NTG and closely monitored. Clinical information was subsequently abstracted from medical records and compared with data from previous reviews. RESULTS: Tocolytic treatment was successful in all cases (22 of 22, 100%). Complications were clinically insignificant. The most common problem was transient hypotension, which occurred in 9 of 22 (41%) cases. CONCLUSION: NTG is an effective tocolytic with minimal complications, rapid onset, and a brief half-life. These characteristics favor its use during select obstetric procedures. However, strict adherence to protocols for administration is advised.

^© Macmillan Publishers Ltd 2000