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© 2002 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 21:831-836 • 0278-4297

A Long-term Transdermal Nitric Oxide Donor Improves Uteroplacental Circulation in Women With Preeclampsia

Mikiya Nakatsuka, MD, PhD, Masayo Takata, MD, Katsuhiko Tada, MD, PhD, Kazuo Asagiri, MD, Toshihiro Habara, MD, Soichi Noguchi, MD and Takafumi Kudo, MD, PhD

Department of Obstetrics and Gynecology, Okayama University Medical School, Okayama, Japan.

Address correspondence and reprint requests to Mikiya Nakatsuka, MD, PhD, Department of Obstetrics and Gynecology, Okayama University Medical School, 2-5-1 Shikata, Okayama City, Okayama 700-8558, Japan.

Objective. To determine the effects of long-term transdermal administration (range, 4–30 days; mean ± SD, 11.1 ± 7.2 days) of isosorbide dinitrate, a nitric oxide donor, in preeclamptic women. Methods. We studied uterine and fetoplacental circulation of 12 preeclamptic women with oligohydramnios and an elevated pulsatility index in the uterine arteries. Results. Transdermal isosorbide dinitrate significantly suppressed the blood pressure of patients. Pulsed Doppler ultrasonography revealed that the average pulsatility index in the uterine arteries was significantly reduced by treatment with isosorbide dinitrate (P < .003). The average pulsatility index in the umbilical artery was also significantly reduced (P < .004). Furthermore, the size of the amniotic fluid pocket increased approximately 4-fold by treatment with isosorbide dinitrate. Conclusions. Long-term transdermal administration of isosorbide dinitrate improves fetoplacental circulation and may be effective therapy for avoiding maternal hypertension and oligohydramnios in some preeclamptic women.

Abbreviations: ISDN, isosorbide dinitrate • MCA, middle cerebral artery • NO, nitric oxide • PI, pulsatility index • UA, umbilical artery

Key Words: nitric oxide • oligohydramnios • preeclampsia • pregnancy • pulsed Doppler ultrasonography • uterine arteries




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Copyright © 2002 by the American Institute of Ultrasound in Medicine.