2019
DOI: 10.1002/uog.20201
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Antenatal therapy with sildenafil: don't throw the baby out with the bathwater

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Cited by 14 publications
(13 citation statements)
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“… 32 While this effect was not confirmed in other trial arms, prenatal use of sildenafil was since banned from further application despite our appeal to keep its indication for CDH. 33 , 34 Similarly, we conclude that based on our findings any investigation of prenatal treprostinil in conditions with normal lung development should be avoided, at least until the pathophysiologic mechanism is better understood.…”
Section: Discussionmentioning
confidence: 60%
“… 32 While this effect was not confirmed in other trial arms, prenatal use of sildenafil was since banned from further application despite our appeal to keep its indication for CDH. 33 , 34 Similarly, we conclude that based on our findings any investigation of prenatal treprostinil in conditions with normal lung development should be avoided, at least until the pathophysiologic mechanism is better understood.…”
Section: Discussionmentioning
confidence: 60%
“…The findings of the aforementioned studies might therefore not be applicable to fetuses without growth restriction. We have previously argued that prenatal sildenafil therapy should remain considered in CDH, primarily due to the different pulmonary pathophysiology between CDH and IUGR [40]. We and others have previously demonstrated in rat and rabbit models of CDH that the effect of antenatal sildenafil on hypoplastic versus control lungs is different [14, 15].…”
Section: Discussionmentioning
confidence: 99%
“…When sildenafil was given to rodents and rabbits without DH, it decreased the number of distal vessels and decreased total vascular volume. Given the recent safety concerns regarding the use of antenatal sildenafil to treat intrauterine growth restriction (STRIDER), these worrying findings in rodents and rabbits may require further investigation in the lamb DH model before antenatal sildenafil treatment is considered for mild and moderate CDH cases that may not have significantly abnormal pulmonary vascular development.…”
Section: Discussionmentioning
confidence: 99%