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Gupta S, Chauhan M, Sen J, et al. Effect of Transdermal Nitroglycerine on Doppler Velocity Waveforms of the Uterine, Umbilical and Fetal Middle Cerebral Arteries in Patients with Chronic Placental Insufficiency: A Prospective RCT. J Clin Diagn Res. 2017;11(7):QC13-QC17doi: 10.7860/JCDR/2017/21438.10282.
Gupta, S., Chauhan, M., Sen, J., & Nanda, S. (2017). Effect of Transdermal Nitroglycerine on Doppler Velocity Waveforms of the Uterine, Umbilical and Fetal Middle Cerebral Arteries in Patients with Chronic Placental Insufficiency: A Prospective RCT. Journal of clinical and diagnostic research : JCDR, 11(7), QC13-QC17. https://doi.org/10.7860/JCDR/2017/21438.10282
Gupta, Suruchi, et al. "Effect of Transdermal Nitroglycerine on Doppler Velocity Waveforms of the Uterine, Umbilical and Fetal Middle Cerebral Arteries in Patients with Chronic Placental Insufficiency: A Prospective RCT." Journal of clinical and diagnostic research : JCDR vol. 11,7 (2017): QC13-QC17. doi: https://doi.org/10.7860/JCDR/2017/21438.10282
Gupta S, Chauhan M, Sen J, Nanda S. Effect of Transdermal Nitroglycerine on Doppler Velocity Waveforms of the Uterine, Umbilical and Fetal Middle Cerebral Arteries in Patients with Chronic Placental Insufficiency: A Prospective RCT. J Clin Diagn Res. 2017 Jul;11(7):QC13-QC17. doi: 10.7860/JCDR/2017/21438.10282. Epub 2017 Jul 01. PMID: 28892981; PMCID: PMC5583822.
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J Clin Diagn Res. 2017 Jul;11(7):QC13-QC17. doi: 10.7860/JCDR/2017/21438.10282. Epub 2017 Jul 01.

Effect of Transdermal Nitroglycerine on Doppler Velocity Waveforms of the Uterine, Umbilical and Fetal Middle Cerebral Arteries in Patients with Chronic Placental Insufficiency: A Prospective RCT.

Journal of clinical and diagnostic research : JCDR

Suruchi Gupta, Meenakshi Chauhan, Jyotsna Sen, Smiti Nanda

Affiliations

  1. Medical Officer, Department of Obstetrics and Gynaecology, Safdurjung Hospital, Delhi, India.
  2. Professor, Department of Obstetrics and Gynaecology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India.
  3. Professor, Department of Radiodiagnosis, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India.
  4. Professor and Head of Department, Department of Obstetrics and Gynaecology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India.

PMID: 28892981 PMCID: PMC5583822 DOI: 10.7860/JCDR/2017/21438.10282

Abstract

INTRODUCTION: Increase in Nitric Oxide (NO) may be important in vascular adaptation needed to accommodate increased uteroplacental blood flow as pregnancy advances. Hence, in certain conditions like Pregnancy Induced Hypertension (PIH) and Fetal Growth Restriction (FGR), NO donors may play an effective role in increasing uteroplacental perfusion. Transdermal route appears to be a safe and effective route.

AIM: To evaluate the effect of nitroglycerine patch on Doppler velocity waveforms of the uterine, umbilical and fetal middle cerebral arteries in patients with chronic placental insufficiency.

MATERIALS AND METHODS: A prospective randomized controlled clinical trial was conducted on eighty consecutive pregnant women with FGR with or without PIH and having evidence of altered waveform velocimetry in uterine, umbilical and fetal middle cerebral artery. They were divided into two groups- study and control group. Transdermal nitroglycerine patch (10 mg per 24 hours) was applied in study group for three consecutive days. Changes in various Doppler indices were noted after three days of patch application and compared between the two groups. Analysis was carried out using SPSS (Statistical Package for Social Studies) for Windows version 20.0 and online GraphPad software (Prism 5 for Windows) version 5.01.

RESULTS: A significant fall in the systolic and diastolic ratio (S/D), Pulsatility Index (PI) and Resistivity Index (RI) of the uterine (3.07±0.52, 1.04±0.14 and 0.54±0.10 respectively, p<0.001) and umbilical artery (3.73±3.30, 1.18±0.21and 0.64±0.07 respectively, p<0.001) was noted after three days of patch application. No such significant change was observed in the middle cerebral artery indices.

CONCLUSION: The therapeutic approach of NO donor administration via transdermal route in pregnant patients with chronic placental insufficiency, apparently improved both maternal and fetoplacental haemodynamics, thus may help in improving perinatal outcome.

Keywords: Nitric oxide; Pregnancy; Pulsatility index; Resistivity index; S/D ratio

References

  1. Obstet Gynecol. 1996 Feb;87(2):249-53 - PubMed
  2. J Ultrasound Med. 2002 Aug;21(8):831-6 - PubMed
  3. Obstet Gynecol. 1995 Oct;86(4 Pt 1):600-4 - PubMed
  4. Am J Obstet Gynecol. 1991 Feb;164(2):507-13 - PubMed
  5. Endocrinology. 1993 Oct;133(4):1899-902 - PubMed
  6. Lancet. 1992 Oct 3;340(8823):856 - PubMed
  7. Am J Hypertens. 1999 Apr;12(4 Pt 1):341-7 - PubMed
  8. Anesthesiology. 1980 May;52(5):390-4 - PubMed
  9. Am J Obstet Gynecol. 1991 Feb;164(2):687-92 - PubMed
  10. Biochem Biophys Res Commun. 1994 May 16;200(3):1630-4 - PubMed
  11. Int J Gynaecol Obstet. 2001 Jun;73(3):201-6 - PubMed
  12. Ultrasound Obstet Gynecol. 2005 Jun;25(6):566-72 - PubMed
  13. Lancet. 1994 May 28;343(8909):1325-6 - PubMed
  14. Am J Obstet Gynecol. 1994 Jan;170(1 Pt 1):236-45 - PubMed
  15. Am J Obstet Gynecol. 1998 Jul;179(1):140-5 - PubMed
  16. Proc Natl Acad Sci U S A. 1991 Jun 1;88(11):4651-5 - PubMed
  17. Eur J Obstet Gynecol Reprod Biol. 1997 Jun;73(2):139-43 - PubMed
  18. Gynecol Obstet Invest. 1999;47(1):13-9 - PubMed
  19. Clin Sci (Lond). 1994 Feb;86(2):195-202 - PubMed
  20. Hypertens Pregnancy. 2004;23(1):37-46 - PubMed
  21. Am J Physiol. 1997 Feb;272(2 Pt 2):R441-63 - PubMed

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