Treatment of Preterm Cervical Dilatation with Glyceryl Trinitrate, a Nitric Oxide Donor

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Abstract
We report an observational study on the use of transdermal glyceryl trinitrate as a treatment to delay delivery of women presenting in pregnancy with dilatation of the cervix. Ten women found to have cervical dilatation more than 2 cm (range 2 to 8 cm) at gestations between 16 and 32 weeks were studied. These women were treated with 50 mg glyceryl trinitrate patches. The mean prolongation of gestation from the time of admission was 46.2 days (range 1 to 130 days). There was 1 stillbirth 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 maternal side-effect was headache. No adverse fetal effects were noted. We conclude that glyceryl trinitrate may provide an effective and safe method of tocolysis, well suited for long-term use. The purpose of reporting this study is to highlight the mounting accumulation of data on glyceryl trinitrate and reinforce the need to evaluate its use in randomized controlled trials.