Sildenafil Citrate and Uteroplacental Perfusion in Fetal Growth Restriction

ABSTRACT Background: 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. Objective: To evaluate effectiveness and safety of Sildenafil citrate for treatment of intrauterine growth restriction (IUGR). Design: A prospective randomized control study. Setting: At Ain shams University hospital and KafrAldwwar main Hospital in El-Beheria governorate. Subjects: Eighty pregnant women with gestational age between 24 and 34 weeks having singleton pregnancy and suffering from IUGR attending an antenatal clinic. Methods: 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. Main outcome measure: Length of pregnancy, neonatal weight and ICU admission. Results: Sildenafil treatment was associated with a significant increase in length of pregnancy (P> 0.05) and a significant increase in estimated fetal weight by ultrasound (P