{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:00:13Z","timestamp":1760234413279,"version":"build-2065373602"},"reference-count":15,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T00:00:00Z","timestamp":1620777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/medicina57050478","type":"journal-article","created":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T22:46:14Z","timestamp":1620859574000},"page":"478","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Successful Use of Nitroglycerin for Uterine Hyperstimulation with Fetal Heart Rate Abnormality Caused by a Controlled-Release Dinoprostone Vaginal Delivery System (PROPESS): A Case Report"],"prefix":"10.3390","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5761-8026","authenticated-orcid":false,"given":"Sho","family":"Takakura","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1760-691X","authenticated-orcid":false,"given":"Hiroaki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naosuke","family":"Enomoto","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shintaro","family":"Maki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1489-4810","authenticated-orcid":false,"given":"Tomoaki","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,12]]},"reference":[{"key":"ref_1","first-page":"CD003246","article-title":"Intravenous oxytocin alone for cervical ripening and induction of labour","volume":"2009","author":"Alfirevic","year":"2009","journal-title":"Cochrane Database Syst Rev."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists (2009). ACOG Practice Bulletin No. 107: Induction of labor. Obstet. Gynecol., 114, 386\u2013397.","DOI":"10.1097\/AOG.0b013e3181b48ef5"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1080\/01443610500160121","article-title":"Induction of labour: How close to the evidence-based guidelines are we?","volume":"25","author":"Nooh","year":"2005","journal-title":"J. Obstet. Gynaecol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1111\/jog.14472","article-title":"Efficacy and safety of controlled-release dinoprostone vaginal delivery system (PROPESS) in Japanese pregnant women requiring cervical ripening: Results from a multicenter, randomized, double-blind, placebo-controlled phase III study","volume":"47","author":"Itoh","year":"2021","journal-title":"J. Obstet. Gynaecol. 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