Sildenafil citrate therapy in intrauterine growth restriction with oligohydramnios

Abstract

Background:Several short term and long-term adverse sequelae are linked with foetal growth restriction. In this study, the efficacy of Sildenafil citrate in improving the uteroplacental flow in pregnancies with intrauterine growth restriction was assessed.Objectives:1.To evaluate whether there is increase in uteroplacental blood flow in IUGR following sildenafil citrate therapy. 2.To assess the potential benefits of sildenafil in IUGR, by serially measuring fetal abdominal circumference (AC) by ultrasonographyMaterials & Methods:Pregnant mothers in 24-33 weeks of gestational age having IUGR were randomized into two groups; Group A received 25 mg tablet of sildenafil citrate orally daily and Group B received no treatment. Maternal outcome like Gestational age at delivery and intervention to delivery interval (in days) were noted. Foetal outcomes like increase in foetal abdominal circumference (AC) by ultrasonography, change in pulsatilityindex in umbilical artery and change in Amniotic Fluid Index and birth weight were noted. Results:Mean birth weight with Sildenafil treatment was 2185 gram versus 2050 gram in the control group.  AC growth velocity showed significant increase in mothers with sildenafil therapy (p 0.013). There was statistically significant decrease in pulsatility index value in umbilical artery in sildenafil treated group within 48 hours indicates increase in diastolic blood flow.Conclusion: Sildenafil treatment in IUGR showed trend in increase in birth weight of babies with increase in AC growth velocity, increasing trend in AFI with improved Doppler velocimetry, thus have a promising role in the management of IUGR.