Doppler umbilical artery and middle cerebral artery flowmetry in foetuses affected by foetal growth restriction (FGR) treated with transdermal nitroglycerin

Objective. The objective was the evaluation of Doppler velocimetry of the umbilical artery and middle cerebral artery in foetuses affected by late foetal growth restriction (FGR) treated with transdermal nitroglycerin (Nitroderm®).
Materials and Methods. This is a retrospective study conducted at the University of Messina between 2019 and 2023, on 28 pregnant patients affected by late FGR, between 28 and 36 weeks of gestation. Half a transdermal patch of 5 mg nitroglycerin was applied to the patient’s back for a maximum of twelve hours/day for 10- 14 days. The foetal flowmetry study of the umbilical (AO) and middle cerebral artery (ACM) was performed at the admission time and re-evaluated every other day during treatment with Nitroderm TTS. The statistical analysis was performed considering the first and the last values of AO and ACM pulsatility index (PI).
Results. 17.85% of patients were affected by gestational hypertension, and 3.57% by gestational diabetes. Totally they underwent to 11.46 days ± 2.83 of treatment. The mean value of AO PI at the admission was 1.45 ± 0.05, after treatment was 1.35 ± 0.04. This reduction was statistically significant (p < 0.05). The mean value of ACM PI at the admission was 1.62 ± 0.06, after treatment was 1.65 ± 0.04. Almost all patients delivered by caesarean section (89.28%); only 10.72% gave birth through spontaneous birth.
Conclusions. The treatment with transdermal nitroglycerin (Nitroderm®) is useful to reduce the umbilical Doppler flowmetry in foetuses affected by late FGR but it does not determine any improvement in ACM flowmetry.