Use of Sildenafil Citrate in Woman with Hypertensive Disorders during Pregnancy
Objectives: The aim of this study is to evaluate whether sildenafil citrate (SC) administration is able to prolong
gestation duration to delivery in hypertensive pregnant women and improve maternal and fetal outcomes.
Study design: A randomized controlled trial.
Setting: Obstetrics and Gynecology Department, Faculty of Medicine, South Valley University, Egypt.
Patients: 100 hypertensive pregnant women . Patients were divided randomly into two groups, group A who
receive sildenafil citrate by a dose of 20 mg twice daily in addition to antihypertensive agent . group B who
receive antihypertensive agent only .
Main Outcome Measure(s): (i)Primary outcome: Gestational age at time of termination , maternal outcomes .
(ii)Secondary outcome: Neonatal outcome: Neonatal outcome in terms of survival and neonatal well-being
(by obtaining the birth weight and the APGAR score at 1 and 5 minutes and direct postnatal need to NICU).
Control of maternal blood pressure.
Result(s): gestational duration was significantly prolonged in sildenafil group in comparison to controlled
group , ( in days) ( 261.66±5.83 ) with a range of (241-270 ) in sildenafil group ,while ( 257.38±6.16 ) with a
range of (238-266 ) in controlled group .Systolic and diastolic blood pressure are significantly lowered in
sildenafil group than controlled group .
Amniotic fluid index was significantly increased in sildenafil group in comparison to controlled group .
APGAR score in sildenafil group was significantly increased in comparison to controlled group .
Neonatal weight in sildenafil group was significantly increased in comparison to control group .
Conclusion(s): Administration of sildenafil citrate to hypertensive pregnant women appeared to help to prolong
gestational duration .
Sildenafil citrate helps to control systolic and diastolic blood pressure in hypertensive pregnant women .
Administration of sildenafil citrate to hypertensive pregnant women helps significantly in increasing AFI .
NO statistically significant difference was observed between studied groups regarding occurrence of APH and HELLP
Future studies with large sample size are needed to evaluate role of sildenafil citrate in hypertensive pregnant women .