Effect of a nitric oxide donor on maternal hemodynamics in fetal growth restriction

Ultrasound Obstet Gynecol. 2018 Apr;51(4):514-518. doi: 10.1002/uog.17454.

Abstract

Objective: To evaluate the effect on maternal cardiovascular parameters of treatment with a nitric oxide (NO) donor and plasma volume expansion in pregnancies complicated by fetal growth restriction (FGR).

Methods: Twenty-six pregnant women with a diagnosis of FGR were treated with transdermal patches of a NO donor and plasma volume expansion by co-administration of oral fluids. We compared the treated group to a historical control group of untreated FGR patients. Hemodynamic indices were obtained using the UltraSonic Cardiac Output Monitor system.

Results: At diagnosis, the two groups were similar in terms of maternal and hemodynamic characteristics. In the treated group, we found a significant increase in maternal cardiac output and stroke volume and a decrease in systemic vascular resistance after 2 weeks of therapy. No significant differences were found 2 weeks after diagnosis in the untreated group. The treated group delivered infants with higher birth-weight centile than did the untreated control group.

Conclusions: The combined therapeutic approach of NO donor administration and plasma volume expansion in FGR apparently improves significantly maternal hemodynamic indices. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

Keywords: FGR; NO donor; TVR; USCOM; UltraSonic Cardiac Output Monitor; fetal growth restriction; maternal hemodynamics; nitric oxide donor; total vascular resistance.

Publication types

  • Observational Study

MeSH terms

  • Administration, Cutaneous
  • Adult
  • Birth Weight
  • Blood Pressure / drug effects*
  • Blood Pressure / physiology
  • Case-Control Studies
  • Female
  • Fetal Growth Retardation / diagnostic imaging*
  • Gestational Age
  • Hemodynamics / drug effects
  • Humans
  • Infant
  • Nitric Oxide Donors / administration & dosage
  • Nitric Oxide Donors / pharmacology*
  • Plasma Substitutes / administration & dosage*
  • Plasma Substitutes / pharmacology
  • Pregnancy
  • Prospective Studies
  • Stroke Volume / drug effects*
  • Stroke Volume / physiology
  • Ultrasonography, Prenatal
  • Vascular Resistance / drug effects*
  • Vascular Resistance / physiology

Substances

  • Nitric Oxide Donors
  • Plasma Substitutes