Study of effect of sildenafil citrate in pregnant women with intrauterine growth restriction/oligohydramnios

Abstract

Background: Fetal growth restriction affects up to 8% of all pregnancies with early onset and late onset fetal growth restriction with increased perinatal mortality. The objective of the study was to evaluate the effectiveness of Sildenafil citrate, the type 5 phosphodiesterase inhibitor which dilates myometrial arteries and improves uterine blood flow.

Methods: 100 pregnant women with severe early and late onset fetal growth restriction and oligohydramnios, from 2012 to 2015 at Hassan institute of medical sciences, Karnataka, India were selected for the study. Intervention included the administration of Sildenafil citrate 25mg three times daily until delivery and the major outcome variables were Doppler studies of Uterine artery, umbilical artery, MCA and ductus venosus, Amniotic fluid volume and gestational age. Pregnant women were in the age group of 18-36 years and between 22 -34 weeks of gestational age at the time of recruitment into the study. All the subjects were given intervention and monitored for primary outcome variables once in fifteen days with fetal Doppler and ultrasound techniques.

Results: Among the subjects students 2% resulted in stillbirths, 98% retained in the study up to delivery and 80% followed up to three years following delivery. Majority of the women (60%) in the 30 weeks of gestational age and 10% among 22 weeks and 30% between 32-36 weeks of gestation age showed USG abnormalities respectively. Among the USG abnormalities IUGR was found among 70% of women and 30% were found with oligohydramnios before intervention and became 0% and 10% after intervention respectively (p<0.005).

Conclusions: Study concludes that Sildenafil citrate would be useful to improve perinatal outcome in women with IUGR both early onset and late onset and Oligomnios.