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Abstract
Retained placenta occurs 2.0-3.3% of all vaginal deliveries. For management of retained placenta administration of oxytocin to promote uterine contractions combined with controlled umbilical cord traction is usually performed.
When this procedure fails operative manual removal under anesthesia is necessary. General anesthesia is often used since it provides both good analgesia as well as adequate cervico-uterine relaxation necessary for manual removal of the placenta. However general anesthesia is associated with an increased risk of complication such as aspiration pneumonitis homodynamic instability and delayed emergence.hepatic toxicity
Intravenously administered nitroglycerin is effective for successful delivery of retained placenta nitroglycerin is a well known nitric oxide donor induces immediate relaxation of the term pregnant myometrium as well as the uterine cervix. .
Since both oxytocin and nitroglycerin have shown to be beneficial for management of retained placenta, and the injection of oxytocin do not reach the placental bed, furthermore, intravenous nitroglycerine injection take time for management of retained placenta .