Abstracts – 2008 - Obstetricia Crítica

antenatal hospitalization (OR 4.67, 95% CI 2.88-7.57), hypertensive disordersincluding preeclampsia (OR 5.62, 95% CI 2.60-12.15) and a substantial increasein length of hospital stay. Sickle cell disease was associated with an increasedodds of antenatal hospitalization (OR 5.56 95% CI 5.08-6.09), hypertensivedisorders including preeclampsia (OR 1.78, 95% CI 1.48-2.14), and IUGR (OR2.91, 95% CI 2.16-3.93), with a modest increase in length of hospital stay.CONCLUSION: Women with systemic sclerosis, primary pulmonaryhypertension, and sickle cell disease have significantly increased rates ofadverse pregnancy outcomes, requiring extensive preconceptional counselingabout the risks of pregnancy. LEVEL OF EVIDENCE: II.Acta Obstet Gynecol Scand. 2008;87(2):222-5.Sublingual nitroglycerin seems to be effective in the management ofretained placenta.Ekerhovd E, Bullarbo M.Department of Obstetrics and Gynecology, Sahlgrenska University Hospital,Gothenburg, Sweden. erling.ekerhovd@obgyn.gu.seBACKGROUND: A common approach in the management of retained placenta isadministration of oxytocin followed by controlled cord traction. Previously it hasalso been demonstrated that intravenously administered nitroglycerin facilitatesmanual extraction of retained placenta. The purpose of the present trial was toexamine the success rate and safety of sequential administration of intravenousoxytocin in combination with sublingual nitroglycerin for the delivery of retainedplacenta. METHODS: The report is a chart review of 24 women with retainedplacenta despite intravenously administered oxytocin. The women were givensublingual nitroglycerin (1 mg) to promote detachment of the placenta. Some 5min after resorption of the tablets, controlled cord traction was carried out for amaximum of 5 min. In addition, changes in blood pressure following treatmentwith nitroglycerin and total blood loss during delivery were registered. RESULTS:Twenty-one of the women delivered the placenta successfully followingsublingual administration of nitroglycerin. The procedure failed in 3 women andoperative manual removal under regional or general anesthesia was undertaken.No complications due to nitroglycerin were registered. CONCLUSIONS:Sequential administration of oxytocin and nitroglycerin seems to be an effectiveand safe procedure in the management of retained placenta. However, largerstudies are needed to confirm the encouraging results of the present trial.Am J Obstet Gynecol. 2008 Mar;198(3):283.e1-8. Epub 2008 Jan 14.Postpartum dexamethasone for women with hemolysis, elevated liverenzymes, and low platelets (HELLP) syndrome: a double-blind, placebocontrolled,randomized clinical trial.Katz L, de Amorim MM, Figueiroa JN, Pinto e Silva JL.Department of Obstetrics, Professor Fernando Figueira Institute for Maternal andChild Health Care, Recife, Pernambuco, Brazil. katzleila@yahoo.com.brOBJECTIVE: The purpose of this study was to determine the effectiveness ofpostpartum dexamethasone in patients with hemolysis, elevated liver enzymes,