THE EFFECTS OF S-NITROSOGLUTATHIONE ON PLATELET ACTIVATION, HYPERTENSION, AND UTERINE AND FETAL DOPPLER IN SEVERE PREECLAMPSIA

Objective: To determine the effects of the platelet-specific nitric ox ide donor S-nitrosoglutathione on women with severe preeclampsia. Meth ods: Ten women with severe preeclampsia or preeclampsia with severe fe tal compromise at 21-33 weeks' gestation each received a 60-90-minute intravenous infusion of 50-250 mu g/minute of S-nitrosoglutathione. Ea ch was hypertensive, despite conventional oral antihypertensive therap y in eight. Maternal blood pressure, heart rate, platelet activation, uterine artery, and fetal Doppler indices were measured during the inf usion. Results: A dose-dependent reduction in mean arterial pressure f rom 125 mmHg (95% confidence interval ICI] 117-133) to 103.5 (95% CI 9 7-111) (P < .005) and an increase in pulse rate from 73.7 beats per mi nute (95% CI 64.3-84.5) to 89.1 (95% CI 81.2-97.8) (P < .02) was obser ved during the infusion. Mean uterine artery resistance index fell fro m 0.76 (95% CI 0.73-0.81) to 0.70 (95% CI 0.65-0.75) (P < .009). Plate let activation measured by P-selectin expression was reduced from 3.02 % (95% CI 2.09-4.36) to 1.22% (95% CI 0.94-1.58) (P < .01). Fetal Dopp ler indices (umbilical artery, middle cerebral artery, and thoracic ao rta) showed no significant changes during the infusion. Conclusions: S -nitrosoglutathione infusion reduced maternal mean arterial pressure, platelet activation, and uterine artery resistance without further com promising fetal Doppler indices. This study suggests that platelet-spe cific nitric oxide donors may prove beneficial in the management of se vere preeclampsia.