Effect of transdermal nitroglycerin patch on severe preeclamptic women with abnormal Doppler indices

Authors

  • El-Sayed S. El-Ebshehy Department of Obstetrics and Gynecology, Tanta University, Tanta, Egypt
  • Ahmed M. Hagras Department of Obstetrics and Gynecology, Tanta University, Tanta, Egypt
  • Amr T. Elbadry Department of Obstetrics and Gynecology, Tanta University, Tanta, Egypt
  • Ahmed M. Awara Department of Obstetrics and Gynecology, Tanta University, Tanta, Egypt

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20190291

Keywords:

Doppler ultrasound, Severe preeclampsia, Nitric oxide, Nitroderm patch

Abstract

Background: The aim is to evaluate the effect of maternal transdermal nitro-glycerine patch administration on blood flow resistance on maternal uterine artery, fetal umbilical and middle cerebral arteries in patients with severe pre-eclampsia in early gestational age (24 weeks to 33 weeks) associated with abnormal Doppler indices (placental insufficiency) and also its effect on maternal mean arterial blood pressure.

Methods: This is a prospective interventional clinical trial conducted on (50) pregnant women with singleton pregnancy diagnosed with severe pre-eclampsia admitted in high-risk pregnancy unit at the Department of Obstetrics  in Tanta University Hospitals, A 50-mg transdermal GTN patch (Novartis Pharma) was applied to the abdominal skin, releasing nitroglycerin at a rate of 0.4 mg/h. Doppler ultrasonography and measurement of maternal blood pressure were performed before application of transdermal GTN patch, after 4 hours of application, after 24 hours and after 48 hours.

Results: the application of a 50-mg transdermal GTN patch to the maternal abdomen was associated with a significant decline in the PI of the uteroplacental and fetoplacental blood flow. No change was observed in the PI of the cerebral circulation. And also, there was a significant decrease in maternal blood pressure (MAP).

Conclusions: Nitroderm patch (nitric oxide donors) may be used as initial therapy in cases of severe preeclampsia complicated by placental insufficiency in the form of abnormal Doppler indices.

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Published

2019-01-25

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Original Research Articles