Effect of nitric oxide donor and plasma volume expansion on pregnancies with early onset fetal growth restriction: a randomized controlled trial
Year: 2025
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: PURPOSE: To evaluate the effect of nitric oxide (NO) donor, in combination with plasma volume expansion, on both fetal and maternal outcomes in pregnancies complicated by early-onset fetal growth restriction (FGR). METHODS: 5 mg for 12 h daily with plasma volume expansion (PVE) in the form of 2.5 L of water per day. Group B represented the control group. The primary endpoint of the study, assessed after 2 weeks of treatment initiation, focused on fetal growth parameters as the primary outcome. In addition, amniotic fluid volume, umbilical artery Doppler changes, development of fetal complications, maternal vital signs, and any side effects, were recorded. At the time of delivery, the following also documented: timing, mode, and interval to delivery, along with neonatal outcomes. RESULTS: Group A exhibit statistically significant enhancement in fetal growth compared to Group B in terms of estimated fetal weight, abdominal circumference, head circumference, biparietal diameter, femur length, amniotic fluid volume, and umbilical artery pulsatility index. Furthermore, Group A demonstrated more favorable outcomes in terms of gestational age at delivery, interval to delivery, birth weight, APGAR score and rates of NICU admission. CONCLUSION: The combination of NO donors and PVE has shown promising results in enhancing fetal growth and extending gestation. This study adds to the existing body of evidence supporting the effectiveness of NO donor therapy when used in conjunction with fluid management for managing FGR. Nonetheless, additional research is essential to validate these results and refine the treatment strategy for optimal outcomes in affected pregnancies.
Authors: Maya Mahmoud Abdelrazek, Mai Abdelfattah Ahmed, Mohamed Elmandooh Mohamed Ibrahim
Institution: Ain Shams University
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,590
OpenAlex ID: W4408818233