A retrospective interventional study for evaluation of efficacy and safety of sildenafil citrate in improving intrauterine growth restriction and oligohydramnios using ultrasound Doppler velocimetry

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dc.contributor.authorGanla, Kedar N.en_US
dc.contributor.authorChoudhary, Rana A.en_US
dc.contributor.authorDesai, Kavita N.en_US
dc.contributor.authorKadam, Santoshi B.en_US
dc.contributor.authorArunachalam, Krutikaen_US
dc.date.accessioned2020-04-23T07:59:29Z
dc.date.available2020-04-23T07:59:29Z
dc.date.issued2019-12
dc.description.abstractBackground: Intrauterine growth restriction (IUGR) is one of the major reasons for neonatal morbidity and mortality. Oligohydramnios is a common finding in IUGR. In majority of these cases diminished utero-placental blood flow is observed. However, in spite of this understanding and identification of high-risk patients, the management options are limited. Sildenafil citrate, a phosphodiesterase type-5 inhibitor improves utero-placental perfusion.Methods: We present a retrospective interventional study involving 50 adult pregnant women diagnosed with early-onset IUGR (n=38) and oligohydramnios (n=12). Vaginal sildenafil citrate 25 mg t.i.d. was started from the day of diagnosis till delivery. Primary efficacy endpoints included changes in Doppler parameters i.e., amniotic fluid index (AFI), uterine artery (UA)- pulsatility index (PI), resistance index (RI) and systolic diastolic ratio (S/D ratio). Secondary endpoints included live birth, birth weight, Apgar score at birth, neonatal survival to hospital discharge and adverse maternal side effects.Results: There was a statistically significant improvement in UA-PI, RI and S/D ratios (p<0.0001) in all cases. In oligohydramnios cases, treatment showed a statistical significant increase in AFI score (2.86±1.33 cm). The mean birth weight on delivery was 2200 gm with good Apgar scores. No major adverse effects were reported by women using sildenafil citrate vaginally.Conclusions: Sildenafil citrate, by increasing utero-placental perfusion, improves uterine artery Doppler patterns, AFI, fetal weight and overall better neonatal survival rates by reducing neonatal morbidity and mortality. Sildenafil citrate may hold a promising treatment strategy for management of IUGR and oligohydramnios.en_US
dc.identifier.affiliationsDepartment of Reproductive Medicine, Ankoor Fertility Clinic, Mumbai, Indiaen_US
dc.identifier.affiliationsDadar Imaging and Diagnostic Centre, Mumbai, Indiaen_US
dc.identifier.affiliationsMedical Services, Akumentis Healthcare Ltd., Thane, Maharashtra, Indiaen_US
dc.identifier.citationGanla Kedar N., Choudhary Rana A., Desai Kavita N., Kadam Santoshi B., Arunachalam Krutika. A retrospective interventional study for evaluation of efficacy and safety of sildenafil citrate in improving intrauterine growth restriction and oligohydramnios using ultrasound Doppler velocimetry. International Journal of Basic & Clinical Pharmacology. 2019 Dec; 8(12): 2736-2740en_US
dc.identifier.issn2319-2003
dc.identifier.issn2279-0780
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/200461
dc.languageenen_US
dc.publisherMedip Academyen_US
dc.relation.issuenumber12en_US
dc.relation.volume8en_US
dc.source.urihttps://dx.doi.org/10.18203/2319-2003.ijbcp20195288en_US
dc.subjectIUGRen_US
dc.subjectOligohydramniosen_US
dc.subjectSildenafil citrateen_US
dc.subjectUtero-placental blood flowen_US
dc.subjectDoppleren_US
dc.titleA retrospective interventional study for evaluation of efficacy and safety of sildenafil citrate in improving intrauterine growth restriction and oligohydramnios using ultrasound Doppler velocimetryen_US
dc.typeJournal Articleen_US
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