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

ObjectiveTo 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).MethodsTwenty-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.ResultsAt 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 2weeks of therapy. No significant differences were found 2weeks after diagnosis in the untreated group. The treated group delivered infants with higher birth-weight centile than did the untreated control group.ConclusionsThe combined therapeutic approach of NO donor administration and plasma volume expansion in FGR apparently improves significantly maternal hemodynamic indices. Copyright (c) 2017 ISUOG. Published by John Wiley & Sons Ltd.