Evaluation of Addition Of Sildenafil Citrate On Fetal Growth And Doppler Indices In Treatment of Pregnancy Induced Hypertension
Farid, E., Abdel-wahed, H., Hemida, H. (2022). Evaluation of Addition Of Sildenafil Citrate On Fetal Growth And Doppler Indices In Treatment of Pregnancy Induced Hypertension. EKB Journal Management System, 3(1), 68-83. doi: 10.21608/ejmr.2022.216583
Eman Zein Elabdein Farid; Hamada Ashry Abdel-wahed; Heba Abdel-Aleem Hemida. "Evaluation of Addition Of Sildenafil Citrate On Fetal Growth And Doppler Indices In Treatment of Pregnancy Induced Hypertension". EKB Journal Management System, 3, 1, 2022, 68-83. doi: 10.21608/ejmr.2022.216583
Farid, E., Abdel-wahed, H., Hemida, H. (2022). 'Evaluation of Addition Of Sildenafil Citrate On Fetal Growth And Doppler Indices In Treatment of Pregnancy Induced Hypertension', EKB Journal Management System, 3(1), pp. 68-83. doi: 10.21608/ejmr.2022.216583
Farid, E., Abdel-wahed, H., Hemida, H. Evaluation of Addition Of Sildenafil Citrate On Fetal Growth And Doppler Indices In Treatment of Pregnancy Induced Hypertension. EKB Journal Management System, 2022; 3(1): 68-83. doi: 10.21608/ejmr.2022.216583

Evaluation of Addition Of Sildenafil Citrate On Fetal Growth And Doppler Indices In Treatment of Pregnancy Induced Hypertension

Egyptian Journal of Medical Research
Article 6, Volume 3, Issue 1, January 2022, Pages 68-83    PDF (482.58 K)
Document Type: Original Article
DOI: 10.21608/ejmr.2022.216583
Authors
Eman Zein Elabdein Farid; Hamada Ashry Abdel-wahed; Heba Abdel-Aleem Hemida
Obstetrics and Gynecology department, Faculty of Medicine, Beni-Suef University, Egypt
Abstract
Pregnancy induced hypertension (PIH) is the most common complication during pregnancy and it affects up to 12% of pregnancies. It is the leading cause of maternal and fetal morbidity and mortality (1). Sildenafil is a potent and selective inhibitor of cGMP .which results in increased levels of cGMP, leading to smooth muscle relaxation thus mediating improved uteroplacental perfusion and increased fetal growth (12). Objectives:This study is to evaluate effect of sildenafil citrate on fetal growth and Doppler indices in treatment of pregnancy induced hypertension Setting:Department of Obstetrics &Gynecology, Beni-Suef University Hospital. Methods:Patients were divided into two groups: Group A (sildenafil group) were offered Sildenafil 20 mg t.i.d. with a plenty of fluids until delivery in addition to traditional treatment. Group B (Placebo group) received placebo drug with the same shape and texture as sildenafil citrate in addition to traditional treatment.Main outcome measures: Utero placental perfusion, fetal growth and maternal and fetal safety. Results: Sildenafil treatment was associated with a significant decrease of SBP between the two time points (P-value<0.001), a significant decrease of DBP between the two time points (P-value<0.001) and increase in estimated fetal weight by ultrasound (P<0.001). Conclusions: Despite limited data, overall there does not appear to be any severe adverse maternal side effects nor any increase in the rate of stillbirths, neonatal deaths attributed to SC.
Keywords
sildenafil; pregnancy induced hypertension; IUGR; Doppler indices
References
  1. Arshad A, Pasha W, Khattak T, et al. (2011) Impact of Pregnancy Induced Hypertension on Birth Weight of Newborn at Term. Journal of Rawalpindi Medical College (JRMC);15(2):113-115.
  2. Dastjerdi MV, Hosseini S, Bayani L.( 2012) Sildenafil citrate and uteroplacental perfusion in fetal growth restriction. J Res Med Sci; 17:632–636.
  3.  Dhand H, Kumar KH, Dave A.( 2011) Middle cerebral artery Doppler indices better predictor for fetal outcome in IUGR. J Obstet Gynecol India ;61:166–171. doi: 10.1007/s13224-011-0018-7.
  4. El Deeb SIH, El-Bakry MM, Nouh AAA , et al  (2015) prevalence of pregnancy induced hypertension Zagazig university Hospital. Thesis of master degree in obstetrics and Gynecology. Faculty of medicine Zagazig University.
  5. El-Sayed MA, Saleh SA, Maher MA, et al.( 2017) Utero-placental perfusion Doppler indices in growth restricted fetuses: effect of sildenafil citrate. J Matern Fetal Neonatal Med :1–6.
  6. Lindheimer MD, Conrad KP, Karumanchi SA. (2009) Renal Physiology and Disease in Pregnancy. Physiology and Pathophysiology, 4th ed. San Diego, CA: Academic Press, Elsevier; 2339–2398.
  7. Magann EF, Sandlin AT, Ounpraseuth ST.( 2011) Amniotic fluid and the clinical relevance of the sonographically estimated amniotic fluid volume: oligohydramnios. J Ultrasound Med; 30: 1573–85.
  8. Panda S, Das A, Nowroz H.( 2014) Sildenafil Citrate in Fetal Growth Restriction. J Reprod Infertil ;15(3):168‒169.
  9.  Roberts RP, Refuerzo JS, Ferrari F, et al.( 2016) Sildenafil treatment in a nonsevere hypertensive murine model lowers blood pressure without reducing fetal growth.Am J Obstet Gynecol.; 215:386.e1–386.e8. doi: 10.1016/j.ajog.2016.05.002.
  10. Ryan, Roisin M, McCarthy, et al. (2018): Hypertension in pregnancy. .Obstetrics, Gynaecology & Reproductive Medicine, volume 28, Issue 5, Pages 141–147.
  11. Sibai & Baha.M (2003) Diagnosis and Management of Gestational Hypertension and Preeclampsia. Obstetrics and Gynecology; 102(1):181-92.
  12. Stanley, J.L, Andersson, I.J, Poudel, R, et al. (2012) Sildenafil citrate rescues fetal growth in the catechol-O-methyl transferase knockout mouse model. Hypertension 59(5), 1021–1028.  
  13. Trapani A Jr, Gonçalves LF, Trapani TF,   et al. (2016) Perinatal and hemodynamic evaluation of sildenafl citrate for preeclampsia treatment: a randomized controlled trial. Am J Obstet Gynecol; 128:253–259.
  14. Unterscheider J, et al. (2013) Optimizing the definition of intrauterine growth restriction: the multicenter prospective PORTO Study. Am J Obstet Gynecol, Apr;208(4):290.e1-6.
  15. Webb DJ, FreestoneS, AllenMJ, et al. (1999) Sildenafil citrate and blood pressure-lowering drugs: results of drug interaction studies with an organic nitrate and a calcium antagonist. Am J Cardiol ; 83(suppl 5A):21C–28C.
 

 

 

Statistics
Article View: 333
PDF Download: 262