Key result
Vaginal isosorbide mononitrate reduces preeclampsia, preterm birth, and neonatal ICU admissions versus placebo.
Why the study?
Impairment of endogenous nitric oxide is associated with preeclampsia, and prophylactic therapy with nitric oxide donors may improve pregnancy outcomes in high-risk groups.
Does prophylactic vaginal isosorbide mononitrate reduce the incidence of preeclampsia in high-risk teenage primigravidae?
RCT (n=300)
Randomly allocated
Does prophylactic vaginal isosorbide mononitrate reduce the incidence of preeclampsia in high-risk teenage primigravidae?
Answers are grounded in this paper and cite their sources.
Prophylactic vaginal isosorbide mononitrate significantly reduces the incidence of preeclampsia and improves neonatal outcomes in high-risk teenage primigravidae.
OBJECTIVES: Preeclampsia is associated with significant morbidity and mortality especially in high-risk groups. Impairment of endogenous nitric oxide has been shown to be associated with the disease and prophylactic therapy may ameliorate this condition and improve pregnancy outcome. This study valuated nitric oxide donors prophylactic treatment for preeclampsia in high-risk teenage primigravidae. METHODS: The study included three hundred primigravidae aged ≤ 20 years with singleton pregnancy. Abdominal pulsed color Doppler ultrasound was done at 24 weeks gestation and pregnancies with uterine artery diastolic notch were randomly allocated to a control group received placebo vaginal tablets and a study group received isosorbid mononitrate 20 mg tablet once daily applied vaginally until delivery. OUTCOMES: Incidence of preeclampsia and maternal, fetal, and neonatal outcome in both groups. RESULTS: The study group had significant lower incidence of preeclampsia, preterm birth, intrauterine growth restriction and of neonatal admission to the intensive care (p < 0.05). CONCLUSIONS: Nitric oxide donors prophylactic treatment for preeclampsia in high-risk teenage pregnancies decrease the incidence of preeclampsia and improve maternal, fetal, and neonatal outcomes. Further studies on larger sample size are required to confirm these results.
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Razik et al. (2015) conducted an RCT in Preeclampsia (n=300). Isosorbide mononitrate vs. Placebo vaginal tablets was evaluated on Incidence of preeclampsia and maternal, fetal, and neonatal outcome (p=< 0.05). Prophylactic treatment with vaginal isosorbide mononitrate reduced the incidence of preeclampsia, preterm birth, intrauterine growth restriction, and neonatal ICU admission.
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