Will follow up umblical artery Doppler indices for pregnancies with iugr taking placebo and oral isosorbide mononitrate to study its efficacy on the intrauterine growth restricted fetuses
Patients meeting these criteria are to be randomized into one of the following two groups: * Group A (n=23): The Isosorbide Mononitrate group: will receive (IMDUR®, 30 mg, tablet, AstraZeneca, Egypt) (Isosorbide-5-mononitrate Biphasic) twice daily for 4-6 weeks (according to xPharm: The Comprehensive Pharmacology Reference, 2007, Pages 1-4). * Group B (n=23): The placebo group will receive (Osteocare®, tab, VITABIOTICS, Egypt) twice daily for 4-6 weeks Justification: Using PASS 11 program for sample size calculation, setting power at 80% and alpha error at 0.05 and according to "Trapani et al., 2015", the expected change in UTA-PI in isosorbide mononitrate group=21% compared to no change in placebo group. Sample size of 23 women per group will be needed to detect difference between two groups. The study is to be double-blinded, where neither the researcher, nor the participants will know what type of medication each participant will receive, as a nurse will give each patient a closed envelope containing 21 tablets of one of the above two medications in a randomized fashion.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
46
Imdur tablets were given twice daily for 4 weeks
Placebo tablets were given twice daily for 4 weeks
Faculty of Medicine, Ain Shams University
Cairo, Egypt
Reduction in umbilical artery Doppler indices
Measuring of the umbilical artery Doppler resistant index (RI) with the patient in semi recombinant position, during a period of absent fetal movement and breathing. a minimum of three uniform Doppler waveforms will be measured
Time frame: 4 weeks after initiation of treatment
Enhancement of fetal growth as measured by the increase in estimated fetal weight and abdominal circumference
Estimation of fetal weight calculated automatic in the software of the ultrasound scanner utilizing Hadlock's formula (Biparital diameter BPD, Femur length FL, Abdominal circumference AC).
Time frame: 4 weeks after initiation of treatment
Development of fetal complications
IUFD, Fetal distress or deterioration of Doppler indices requiring delivery
Time frame: 4 weeks after initiation of treatment
Interval to delivery
gestational age at delivery in weeks
Time frame: 37 weeks
Maternal side effects
Headache, palpitation, postural hypotension
Time frame: 4 weeks after initiation of treatment
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