title: Intravenous nitroglycerin for intrapartum internal podalic version of the second non-vertex twin.
abstract: OBJECTIVE
  Authors report their experience of intravenous nitroglycerin as uterine relaxing agent for managing successfully internal podalic version of the second twin.
  
  
  METHODS
  From a retrospective study including nine observations of internal podalic version of the second non vertex twin performed with administration of intravenous nitroglycerin, between August 1994 and February 1996, authors compare their results with those reported elsewhere.
  
  
  RESULTS
  Two failures of internal podalic version with nitroglycerin have been observed. But one failure is not considered to be due to the NTG: it was a patient, who had a panic attack necessitating a general anesthesia for sedative purpose. The internal podalic version succeeded. The true failure of NTG needed an emergency cesarean due to acute fetal distress and a non relaxing uterus. One internal podalic version was complicated by hemorrhage. The intravenous NTG used to induce uterine atonia associated with epidural-analgesia to relief pain avoiding general anesthesia makes internal podalic version easier.
  
  
  CONCLUSIONS
  Our results confirmed those already reported. That intravenous nitroglycerin (NTG) injection induces a transient and prompt uterine relaxation required for internal podalic version without affecting maternal and fetal prognosis.
authors.affiliation: Department of Obstetrics and Gynecology, University of Lille, France.
authors.forename: P
authors.initials: P
authors.lastname: Dufour
authors.forename: D
authors.initials: D
authors.lastname: Vinatier
authors.forename: S
authors.initials: S
authors.lastname: Vanderstichèle
authors.forename: D
authors.initials: D
authors.lastname: Subtil
authors.forename: J C
authors.initials: JC
authors.lastname: Ducloy
authors.forename: F
authors.initials: F
authors.lastname: Puech
authors.forename: X
authors.initials: X
authors.lastname: Codaccionni
authors.forename: J C
authors.initials: JC
authors.lastname: Monnier
mesh_terms: D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009126:Muscle Relaxation; D005996:Nitroglycerin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D014427:Twins; D014599:Uterus / Q000502:physiology; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D014710:Version, Fetal / Q000379:methods*
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin