Clinical experience of long-term transdermal treatment with nitric oxide donor for women with preeclampsia.
Isosorbide dinitrate (ISDN), a nitric oxide donor, was applied transdermally for 4-16 days to 4 preeclamptic women with oligohydramnios, intrauterine fetal growth retardation (IUGR), and elevated resistance of blood flow in the uterine arteries. Pulsed Doppler ultrasonography revealed immediate and drastic improvement of pulsatility index (PI) of uterine arteries following treatment with ISDN. The average PI in uterine arteries of the 4 patients was reduced to approximately 67% of that of the untreated state. In 2 patients the amniotic fluid gradually increased over a few days which suggested improvement of fetoplacental circulation during administration of ISDN. This study suggests that long-term transdermal ISDN is an effective therapy, at least in a portion of preeclamptic women, to avoid maternal hypertension, fetal distress, oligohydramnios, and IUGR, and consequentially to prolong the gestational period.
Nakatsuka
M
M
Department of Obstetrics and Gynecology, Okayama University Medical School, Okayama City, Okayama, Japan. mikiya@cc.okayama-u.ac.jp
Tada
K
K
Kimura
Y
Y
Asagiri
K
K
Kamada
Y
Y
Takata
M
M
Nakata
T
T
Inoue
N
N
Kudo
T
T
D000279:Administration, Cutaneous; D000328:Adult; D001158:Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D005317:Fetal Growth Retardation / Q000150:complications; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage / Q000627:therapeutic use*; D020030:Nitric Oxide Donors / Q000008:administration & dosage / Q000627:therapeutic use*; D016104:Oligohydramnios / Q000150:complications; D011225:Pre-Eclampsia / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D011247:Pregnancy; D011673:Pulsatile Flow; D018615:Ultrasonography, Doppler, Color; D014599:Uterus / Q000098:blood supply; D014655:Vascular Resistance
D020030:Nitric Oxide Donors; D007548:Isosorbide Dinitrate