Nitric oxide in the prevention of pre-eclampsia

Objective The purpose of this study was to determine whether nitric oxide improved maternal and fetal outcome in women at high risk for recurrent pre-eclampsia. Study design A total of 68 patients at risk for developing pre-eclampsia were randomly allocated into two arms: one included patients treated with glyceryl trinitrate transdermal patch (5 mg/24 h, Schwarz-Pharma, Italy) for 14-16 h/day, starting from the 16th until the 38th week and one consisting of patients undergoing observation only. Results The occurrence of pre-eclampsia was similar in the two groups, being 31.6% in the treated women and 23.4% in the untreated ones. The patients treated with glyceryl trinitrate showed a neonatal birth weight, gestational age at delivery, rate of emergency Caesarean section and rate of premature delivery similar to those of the untreated group. At entry, the bilateral notches on the uterine arteries were similar. At the 24th week, patients treated with glyceryl trinitrate showed a significant reduction in the bilateral notch (p < 0.05). No change in the umbilical artery and middle-cerebral artery pulsatility indices were observed in the two groups. Conclusions Nitric oxide donor significantly improved uteroplacental blood flow. No change in fetal outcome was observed.