Dietmar Schlembach, Tanja Groten, Thomas Lehmann, Uwe Schneider, Ekkehard Schleussner
Pregnancy Hypertens. 2013 Apr;3(2):62. doi: 10.1016/j.preghy.2013.04.018. Epub 2013 Jun 6.
To evaluate the effectiveness of the oral NO-donor PETN in secondary prevention of intrauterine growth restriction (IUGR), preterm birth and preeclampsia in high risk pregnancies.
111 women presenting with abnormal placental perfusion (bilateral notch or mean RI>0.7) at 19-24weeks of gestation were included in a prospective, randomized, placebo-controlled, double-blinded study. Primary endpoint was IUGR and/or perinatal death, secondary endpoints were preterm birth, preeclampsia and placental abruption.
54 women received PETN and 57 placebo. PETN significantly decreased the risk of IUGR and/or perinatal death (adjusted RR 0.623 [95% - CI: 0.395-0.983]). Preterm birth before 32weeks was reduced (adjusted RR 0.359 [95% - CI 0.123-1.054]) and no placental abruption occurred in the PETN, but 5 in the placebo group. There was no reduction of preeclampsia.
Significant reduction of adverse pregnancy outcome might be possible in pregnancies exhibiting abnormal placentation using PETN.
评估口服一氧化氮供体戊四硝酯在高危妊娠中对预防胎儿生长受限（IUGR）、早产和子痫前期的有效性。
111名在妊娠19至24周时出现胎盘灌注异常（双侧切迹或平均阻力指数>0.7）的女性被纳入一项前瞻性、随机、安慰剂对照、双盲研究。主要终点是胎儿生长受限和/或围产期死亡，次要终点是早产、子痫前期和胎盘早剥。
54名女性接受戊四硝酯治疗，57名接受安慰剂治疗。戊四硝酯显著降低了胎儿生长受限和/或围产期死亡的风险（校正风险比0.623 [95%置信区间：0.395 - 0.983]）。32周前的早产有所减少（校正风险比0.359 [95%置信区间0.123 - 1.054]），戊四硝酯组未发生胎盘早剥，而安慰剂组有5例发生。子痫前期没有减少。
对于胎盘形成异常的妊娠，使用戊四硝酯可能显著降低不良妊娠结局。
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