Clinical use of nitric oxide donors and L-arginine in obstetrics.
Nitric oxide (NO) is a free radical that plays a fundamental role in human physiology, being involved in the homeostasis of different functions. In obstetrics this molecule is determinant in the physiology of labor and cervical ripening; it possibly plays a fundamental role in the etiology of preeclampsia and intrauterine growth restriction, and it could also be utilized in view of its ability to induce smooth muscle relaxation. Several clinical trials have ascertained the ability of the topical application of NO donors to promote cervical ripening, and also labor induction. There is much less evidence on the use of NO donors in the vascular complications of pregnancy, either as prophylactics or therapeutic agents. Due to the capacity of NO to promote relaxation of smooth muscle, NO donors have been employed as tocolytics with performance similar to other agents. Moreover, although anecdotal, the experience of sudden uterine relaxation using NO donors in obstetric emergencies remains of great clinical value.
Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy.
Viviana
V
de Pace
Giuseppe
G
Chiossi
Fabio
F
Facchinetti
D000653:Amniotic Fluid / Q000378:metabolism; D001120:Arginine / Q000502:physiology / Q000627:therapeutic use*; D015415:Biomarkers / Q000378:metabolism; D020070:Cervical Ripening / Q000187:drug effects; D005260:Female; D005317:Fetal Growth Retardation / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000188:drug therapy* / Q000503:physiopathology; D007548:Isosorbide Dinitrate / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D009569:Nitric Oxide / Q000502:physiology; D020030:Nitric Oxide Donors / Q000627:therapeutic use*; D009599:Nitroprusside / Q000494:pharmacology / Q000627:therapeutic use; D007752:Obstetric Labor, Premature / Q000517:prevention & control; D011247:Pregnancy; D014590:Uterine Contraction / Q000187:drug effects; D014710:Version, Fetal
D015415:Biomarkers; D020030:Nitric Oxide Donors; D009599:Nitroprusside; D009569:Nitric Oxide; D001120:Arginine; D007548:Isosorbide Dinitrate; C030397:isosorbide-5-mononitrate