Nitric oxide and its role during pregnancy: From ovulation to delivery

H. Maul, M. Longo, George Saade, R. E. Garfield

Research output: Contribution to journalArticle

120 Citations (Scopus)

Abstract

Nitric oxide (NO) is a major paracrine mediator and important regulatory agent in various female reproductive processes, such as ovulation, implantation, pregnancy maintenance, labor and delivery. Ovulation: Circulating NO-products are increased during follicle development and decreased right after ovulation. INOS-inhibition results in a 50% reduction of ovulation, an effect completely reversed by an NO. Endometrium/Implantation: NO also regulates endometrial functions such as endometrial receptivity, implantation and menstruation. NO-donors may be useful for promoting fertility, while NO-inhibitors might be used for contraception. Uterine contractility: Throughout gestation myometrial NO-production is upregulated thus contributing to achieve uterine quiescence. Close to term, NO-production decreases promoting effective contractions resulting in labor. Clinical trials have demonstrated that NO-donors are effective tocolytics. Cervical ripening: In contrast to the myometrium. NO-production in the cervix is low during gestation and becomes upregulated once pregnancy advances to term. NO-donors are effective and safe cervical ripening agents. This finding from animal studies has been confirmed by several clinical trials. Vasoreactivity: In blood vessels, NO is a potent vasodilator and platelet-aggregation-inhibitor. Lack of NO during gestation was related to the development of pregnancy-induced hypertension and preeclampsia. In conclusion, NO-donors and NOS-inhibitors may provide novel, effective, safe, and inexpensive drugs to regulate and steer various functions in female reproductive life. The benefits reach from contraception to preventing possibly lethal pregnancy complications such as preeclampsia. Introducing NO-donors as tocolytics and cervical ripening agents may contribute to a reduction of fetal and maternal perinatal morbidity and mortality.

Original languageEnglish (US)
Pages (from-to)359-380
Number of pages22
JournalCurrent Pharmaceutical Design
Volume9
Issue number5
DOIs
StatePublished - 2003

Fingerprint

Ovulation
Nitric Oxide
Pregnancy
Nitric Oxide Donors
Cervical Ripening
Tocolytic Agents
Pre-Eclampsia
Contraception
Multifetal Pregnancy Reduction
Clinical Trials
Pregnancy Maintenance
Pregnancy Induced Hypertension
Menstruation
Pregnancy Complications
Myometrium
Maternal Mortality
Perinatal Mortality
Platelet Aggregation Inhibitors
Endometrium
Vasodilator Agents

ASJC Scopus subject areas

  • Molecular Medicine
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Nitric oxide and its role during pregnancy : From ovulation to delivery. / Maul, H.; Longo, M.; Saade, George; Garfield, R. E.

In: Current Pharmaceutical Design, Vol. 9, No. 5, 2003, p. 359-380.

Research output: Contribution to journalArticle

Maul, H. ; Longo, M. ; Saade, George ; Garfield, R. E. / Nitric oxide and its role during pregnancy : From ovulation to delivery. In: Current Pharmaceutical Design. 2003 ; Vol. 9, No. 5. pp. 359-380.
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