title: Effect of a nitric oxide donor on maternal hemodynamics in fetal growth restriction.
abstract: OBJECTIVE
  To 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).
  
  
  METHODS
  Twenty-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.
  
  
  RESULTS
  At 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 2 weeks of therapy. No significant differences were found 2 weeks after diagnosis in the untreated group. The treated group delivered infants with higher birth-weight centile than did the untreated control group.
  
  
  CONCLUSIONS
  The combined therapeutic approach of NO donor administration and plasma volume expansion in FGR apparently improves significantly maternal hemodynamic indices. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Rome 'Tor Vergata', Rome, Italy.
authors.forename: G M
authors.identifier: http://orcid.org/0000-0002-0742-459X
authors.initials: GM
authors.lastname: Tiralongo
authors.affiliation: Department of Obstetrics and Gynaecology, University of Rome 'Tor Vergata', Rome, Italy.
authors.forename: I
authors.identifier: http://orcid.org/0000-0001-9914-2153
authors.initials: I
authors.lastname: Pisani
authors.affiliation: Department of Obstetrics and Gynaecology, Policlinico Casilino, Rome, Italy.
authors.forename: B
authors.identifier: http://orcid.org/0000-0002-4942-5742
authors.initials: B
authors.lastname: Vasapollo
authors.affiliation: Fetal Medicine Unit, St George's Hospital, University of London, London, UK.
authors.forename: A
authors.identifier: http://orcid.org/0000-0003-2802-7670
authors.initials: A
authors.lastname: Khalil
authors.affiliation: Fetal Medicine Unit, St George's Hospital, University of London, London, UK.
authors.forename: B
authors.initials: B
authors.lastname: Thilaganathan
authors.affiliation: Department of Obstetrics and Gynaecology, University of Rome 'Tor Vergata', Rome, Italy.
authors.forename: H
authors.initials: H
authors.lastname: Valensise
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D001724:Birth Weight; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007223:Infant; D020030:Nitric Oxide Donors / Q000008:administration & dosage / Q000494:pharmacology*; D010952:Plasma Substitutes / Q000008:administration & dosage* / Q000494:pharmacology; D011247:Pregnancy; D011446:Prospective Studies; D013318:Stroke Volume / Q000187:drug effects* / Q000502:physiology; D016216:Ultrasonography, Prenatal; D014655:Vascular Resistance / Q000187:drug effects* / Q000502:physiology
chemical_list: D020030:Nitric Oxide Donors; D010952:Plasma Substitutes
keywords: FGR; NO donor; TVR; USCOM; UltraSonic Cardiac Output Monitor; fetal growth restriction; maternal hemodynamics; nitric oxide donor; total vascular resistance