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The patients were randomly assigned into two groups, 20 in each group. Group A received Nitroderm TTS <jats:sup>\u00ae<\/jats:sup> 5\u00a0mg for 12\u00a0h daily with plasma volume expansion (PVE) in the form of 2.5\u00a0L of water per day. Group B represented the control group. The primary endpoint of the study, assessed after 2\u00a0weeks of treatment initiation, focused on fetal growth parameters as the primary outcome. In addition, amniotic fluid volume, umbilical artery Doppler changes, development of fetal complications, maternal vital signs, and any side effects, were recorded. At the time of delivery, the following also documented: timing, mode, and interval to delivery, along with neonatal outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Group A exhibit statistically significant enhancement in fetal growth compared to Group B in terms of estimated fetal weight, abdominal circumference, head circumference, biparietal diameter, femur length, amniotic fluid volume, and umbilical artery pulsatility index. Furthermore, Group A demonstrated more favorable outcomes in terms of gestational age at delivery, interval to delivery, birth weight, APGAR score and rates of NICU admission.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The combination of NO donors and PVE has shown promising results in enhancing fetal growth and extending gestation. This study adds to the existing body of evidence supporting the effectiveness of NO donor therapy when used in conjunction with fluid management for managing FGR. Nonetheless, additional research is essential to validate these results and refine the treatment strategy for optimal outcomes in affected pregnancies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00404-025-07988-7","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T03:28:32Z","timestamp":1742959712000},"page":"1435-1444","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effect of nitric oxide donor and plasma volume expansion on pregnancies with early onset fetal growth restriction: a randomized controlled trial"],"prefix":"10.1007","volume":"311","author":[{"given":"Maya Mahmoud","family":"Abdelrazek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai Abdelfattah","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Elmandooh Mohamed","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"key":"7988_CR1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17814","author":"R Katie Morris","year":"2024","unstructured":"Katie Morris R, Johnstone E, Lees C, Morton V, Smith G, the Royal College of Obstetricians and Gynaecologists (2024) Investigation and care of a small-for-gestational-age fetus and a growth restricted fetus (Green-top Guideline No 31). 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