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Updated: May 20, 2025
Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
Effect of nitric oxide donor and plasma volume expansion on pregnancies with early onset fetal growth restriction: a
Maya Mahmoud Abdelrazek1, Mai Abdelfattah Ahmed2, Mohamed Elmandooh Mohamed Ibrahim2
1Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. dr_maya89@med.asu.edu.eg.
Purpose:
To evaluate the effect of nitric oxide (NO) donor, in combination with plasma volume expansion, on both fetal and maternal outcomes in pregnancies complicated by early-onset fetal growth restriction (FGR).
Methods:
A total of 40 pregnant women diagnosed with early onset FGR were recruited from Ain Shams University Maternity Hospital between June 2023 to December 2023. The patients were randomly assigned into two groups, 20 in each group. Group A received Nitroderm TTS ® 5 mg for 12 h daily with plasma volume expansion (PVE) in the form of 2.5 L of water per day. Group B represented the control group. The primary endpoint of the study, assessed after 2 weeks of treatment initiation, focused on fetal growth parameters as the primary outcome. In addition, amniotic fluid volume, umbilical artery Doppler changes, development of fetal complications, maternal vital signs, and any side effects, were recorded. At the time of delivery, the following also documented: timing, mode, and interval to delivery, along with neonatal outcomes.
Results:
Group A exhibit statistically significant enhancement in fetal growth compared to Group B in terms of estimated fetal weight, abdominal circumference, head circumference, biparietal diameter, femur length, amniotic fluid volume, and umbilical artery pulsatility index. Furthermore, Group A demonstrated more favorable outcomes in terms of gestational age at delivery, interval to delivery, birth weight, APGAR score and rates of NICU admission.
Conclusion:
The combination of NO donors and PVE has shown promising results in enhancing fetal growth and extending gestation. This study adds to the existing body of evidence supporting the effectiveness of NO donor therapy when used in conjunction with fluid management for managing FGR. Nonetheless, additional research is essential to validate these results and refine the treatment strategy for optimal outcomes in affected pregnancies.
