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Nitric oxide (NO) donors and haemodynamic changes in fetal growth restriction

Tiralongo GM, Pisani I, Vasapollo B, Khalil A, Thilaganathan B, Valensise H

Published: Ultrasound Obstet Gynecol. Accepted Author Manuscript. doi:10.1002/uog.17454

Objective: To evaluate maternal cardiovascular effects of nitric oxide (NO) donors in pregnancies complicated by fetal growth restriction (FGR).

Methods: 26 women with a diagnosis of FGR were treated with transdermal patches of NO donors and plasma volume expansion. We compared the treated group to a control historical FGR untreated group of patients evaluated longitudinally. We obtained haemodynamic indices using UltraSonic Cardiac OutputĀ Monitor system.

Results: At enrolment, the two groups were similar in terms of maternal and haemodynamic characteristics. In the treated group, we found a significant increase in cardiac output, stroke volume and a decrease of systemic vascular resistance after therapy. No significant differences were found after two weeks in the untreated group. At birth the treated group also gave birth to babies with higher birth weight centile.

Conclusions: Despite the observation nature of the data, the combined therapeutic approach of NO donor administration and plasma volume expansion in FGR significantly improves maternal hemodynamic indices.