TREATMENT OF PRETERM CERVICAL DILATATION WITH GLYCERYL TRINITRATE, A NITRIC-OXIDE DONOR

We report an observational study on the use of transdermal glyceryl tr initrate as a treatment to delay delivery of women presenting in pregn ancy with dilatation of the cervix. Ten women found to have cervical d ilatation more than 2 cm (range 2 to 8 cm) at gestations between 16 an d 32 weeks were studied. These women were treated with 50 mg glyceryl trinitrate patches. The mean prolongation of gestation from the time o f admission was 46.2 days (range 1 to 130 days). There was 1 stillbirt h in a 22.6-week fetus and 1 neonatal death secondary to prematurity. Vaginal delivery occurred in all but 3 cases. All babies were of size appropriate for gestational age at delivery. The only reported materna l side-effect was headache. No adverse fetal effects were noted. We co nclude that glyceryl trinitrate may provide an effective and safe meth od of tocolysis, well suited for long-term use. The purpose of reporti ng this study is to highlight the mounting accumulation of data on gly ceryl trinitrate and reinforce the need to evaluate its use in randomi zed controlled trials.