Section 3 Maternal Mortality

**85**

**Chapter 6**

**Abstract**

influence this process.

**1. Introduction**

intrauterine environment

muscles on the reaction of NO [1].

associated with angiogenesis [2].

Maternal and Fetal Complications

Nitric oxide (NO) is synthesized from L-arginine by the constitutive NO synthase in vascular endothelial cells and plays an important role in the regulation of blood pressure and coronary vasomotion. Normal pregnancy is associated with major adaptations in maternal cardiovascular function, which help the woman to accommodate the growing fetus. The vascular endothelium is stimulated during pregnancy to release increased amounts of NO, and the abnormality in the L-arginine NO pathway may play a role in the etiology of preeclampsia. The objective of this study is to discuss the importance of nitric oxide during gestation and the maternal and fetal complications associated with decreased NO synthesis during this period. Maternal arterial hypertension due to inhibition of nitric oxide synthesis during pregnancy impairs fetal development, mainly the reduction of the wall/lumen ratio of the cardiac and renal microvasculature as well as the reduction in the number of nephrons. These changes may contribute to the development of hypertension. Despite these findings, more studies are needed to understand the programming of fetal development, and the intrauterine environmental factors.

Due to Decreased Nitric Oxide

Synthesis during Gestation

**Keywords:** nitric oxide, pregnancy, preeclampsia, growth fetal,

Normal pregnancy is associated with intensive changes in the maternal cardiovascular system that enables adequate oxygen delivery and nutritive ingredients to the fetus. Physiological vascular adaptation (increased blood volume, increased cardiac minute volume, and reduced vascular resistance) is followed by increased endogenous production of nitric oxide (NO) and improved response of smooth

Nitric oxide is synthesized from L-arginine by the constitutive NO synthase in vascular endothelial cells and plays an important role in the regulation of blood pressure and coronary vasomotion. Abnormalities in its production and/or bioavailability are related to diseases such as hypertension, atherosclerosis, and disorders

*Vanessa Souza and Izabela Vieira*

*Sonia Jurado, Kaelly Saraiva, Cauane Marceliano,* 
