Sildenafil Citrate and Uteroplacental Perfusion in Fetal Growth Restriction
Journal Title: The Egyptian Journal of Hospital Medicine - Year 2018, Vol 71, Issue 4
Abstract
<span>Background: </span><span>Severe early-onset fetal growth restriction can lead to a range of adverse outcomes including fetal or neonatal death, neurodisability, and lifelong risks to the health of the affected child. Sildenafil, a phosphodiesterase type 5 inhibitor, potentiates the actions of nitric oxide, which leads to vasodilatation of the uterine vessels and might improve fetal growth in utero.<br /> </span><span>Objective: </span><span>To evaluate effectiveness and safety of Sildenafil citrate for treatment of intrauterine growth restriction (IUGR). </span><span>Design: </span><span>A prospective randomized control study.<br /> </span><span>Setting: </span><span>At Ain shams University hospital and Kafr Aldwwar main Hospital in El-Beheria governorate. </span><span>Subjects: </span><span>Eighty pregnant women with gestational age between 24 and 34 weeks having singleton pregnancy and suffering from IUGR attending an antenatal clinic.<br /> </span><span>Methods: </span><span>Eighty pregnant women with FGR and abnormal umbilical artery Doppler between 24and34 weeks were randomly allocated to sildenafil (n= 40) 25mg tid or placebo (n=40) with a plenty of fluids until delivery. </span><span>Main outcome measure: </span><span>Length of pregnancy, neonatal weight and ICU admission.<br /> </span><span>Results: </span><span>Sildenafil treatment was associated with a significant increase in length of pregnancy (P</span><span>> </span><span>0.05) and a significant increase in estimated fetal weight by ultrasound (P<0.05), and was associated with a significant decrease in neonatal ICU admission (P=0.218) and neonatal mortality (P=0.290).<br /> </span><span>Conclusion: </span><span>Sildenafil citrate can improve utero-placental perfusion and length of pregnancy in pregnancies complicated by IUGR. It appears to have a significantly positive effect on fetal weight. Sildenafil treatment may offer a new opportunity to improve perinatal outcomes, for pregnancies complicated by IUGR. However these observations require further studies on wide scale.<br /> </span>
Authors and Affiliations
Eman Helal
Keywords
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