RETRACTED ARTICLE: Utero-placental perfusion Doppler indices in growth restricted fetuses: effect of sildenafil citrate

Elsayed, Mohamed A.; Saleh, Said; Maher, Mohamed; Khidre, Asmaa Mohamed

doi:10.1080/14767058.2017.1306509

Cited by 38 publications

(57 citation statements)

References 18 publications

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“…This may have represented growth restriction before the onset of advanced disease but may also include some fetuses that were constitutionally small, not at risk and less likely to respond to treatment. Our finding of a short‐term effect on uteroplacental resistance has been demonstrated in other randomised cohorts of fetal growth restriction . This may be sufficient to enhance fetal wellbeing and allow a short pregnancy prolongation and consequent improved perinatal outcomes …”

Section: Discussionsupporting

confidence: 74%

“…Our finding of a short‐term effect on uteroplacental resistance has been demonstrated in other randomised cohorts of fetal growth restriction . This may be sufficient to enhance fetal wellbeing and allow a short pregnancy prolongation and consequent improved perinatal outcomes …”

Section: Discussionsupporting

confidence: 74%

“…Sildenafil was associated with significant pregnancy prolongation and later gestational age at birth. There were no neonatal deaths but further neonatal and longer‐term outcomes were not reported . The STRIDER UK trial followed the same sildenafil dosing regimen as our trial but did not see any difference in perinatal outcomes .…”

Section: Discussionmentioning

confidence: 65%

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STRIDER NZAus: a multicentre randomised controlled trial of sildenafil therapy in early‐onset fetal growth restriction

Groom

McCowan

Mackay

et al. 2019

BJOG

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Objective To assess the effect of maternal sildenafil therapy on fetal growth in pregnancies with early-onset fetal growth restriction.Design A randomised placebo-controlled trial.Setting Thirteen maternal-fetal medicine units across New Zealand and Australia.Population Women with singleton pregnancies affected by fetal growth restriction at 22 +0 to 29 +6 weeks.Methods Women were randomised to oral administration of 25 mg sildenafil citrate or visually matching placebo three times daily until 32 +0 weeks, birth or fetal death (whichever occurred first). Main Outcome MeasuresThe primary outcome was the proportion of pregnancies with an increase in fetal growth velocity. Secondary outcomes included live birth, survival to hospital discharge free of major neonatal morbidity and pre-eclampsia.Results Sildenafil did not affect the proportion of pregnancies with an increase in fetal growth velocity; 32/61 (52.5%) sildenafil-treated, 39/57 (68.4%) placebo-treated [adjusted odds ratio (OR) 0.49, 95% CI 0.23-1.05] and had no effect on abdominal circumference Z-scores (P = 0.61). Sildenafil use was associated with a lower mean uterine artery pulsatility index after 48 hours of treatment (1.56 versus 1.81; P = 0.02). The live birth rate was 56/63 (88.9%) for sildenafil-treated and 47/59 (79.7%) for placebo-treated (adjusted OR 2.50, 95% CI 0.80-7.79); survival to hospital discharge free of major neonatal morbidity was 42/63 (66.7%) for sildenafil-treated and 33/59 (55.9%) for placebo-treated (adjusted OR 1.93, 95% CI 0.84-4.45); and newonset pre-eclampsia was 9/51 (17.7%) for sildenafil-treated and 14/55 (25.5%) for placebo-treated (OR 0.67, 95% CI 0.26-1.75).Conclusions Maternal sildenafil use had no effect on fetal growth velocity. Prospectively planned meta-analyses will determine whether sildenafil exerts other effects on maternal and fetal/neonatal wellbeing.Keywords Fetal growth restriction, intrauterine growth restriction, pre-eclampsia, sildenafil, small for gestational age, uterine artery Doppler.Tweetable abstract Maternal sildenafil use has no beneficial effect on growth in early-onset FGR, but also no evidence of harm.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionsupporting

confidence: 74%

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STRIDER NZAus: a multicentre randomised controlled trial of sildenafil therapy in early‐onset fetal growth restriction

Groom

McCowan

Mackay

et al. 2019

BJOG

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“…Sildenafil citrate is an inhibitor of phosphodiesterase type 5 (PDE-5), the predominant PDE type found in the reproductive tract. 16 Sildenafil has shown promise in cohort studies and randomised studies of fetal growth restriction, [17][18][19][20] pre-eclampsia, 21,22 in animal models, [23][24][25][26][27][28] and in ex-vivo human tissue. [25][26][27][28][29] Global interest in sildenafil as a potential treatment for fetal growth restriction has led to several coordinated national studies that are embedded in the Global Obstetric Network (GONet).…”

Section: Introductionmentioning

confidence: 99%

Maternal sildenafil for severe fetal growth restriction (STRIDER): a multicentre, randomised, placebo-controlled, double-blind trial

Sharp

Cornforth

Jackson

et al. 2018

The Lancet Child & Adolescent Health

173

150

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“…В ряде клинико-экспериментальных исследований также доказана позитивная роль назначения силденафила для улучшения маточно-плацентарного кровообращения при беременности и профилактики синдрома внутриутробной задержки роста плода, внутриутробной гипоплазии легких и легочной гипертензии плода, а также профилактики тератогенного действия на плод, связанного с воздействием некоторых лекарственных препаратов (в частности, вальпроевой кислоты), и снижения выраженности дистресс-синдрома новорожденных [80][81][82][83][84][85][86]. Наряду с этим, в клинических исследованиях продемонстрирована эффективность применения перорального силденафила (по 25 мг каждые 8 часов) в течение 6 недель для увеличения объема амниотической (околоплодной) жидкости у беременных женщин с идиопатическим олигогидроамнионом (маловодием) [87].…”

Section: применение силденафила в акушерстве и гинекологииunclassified

Non-classical effects of sildenafil in clinical medicine: an interdisciplinary approach

Тюзиков¹,

Смирнов

Смирнова³

et al. 2019

Med. sov.

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Based on the results of modern clinical and experimental studies, the review article discusses issues of pharmacotherapeutic feasibility, pathogenetic validity and safety of the first and most studied phosphodiesterase type 5 inhibitor – sildenafil – in general clinical practice according to «non-classical» (non-erectogenic) indications in the framework of an interdisciplinary approach modern medicine. As it is known, at present, phosphodiesterase type 5 inhibitors are both the «first line» therapy for treating erectile dysfunction (as monotherapy), as well as an effective option for monotherapy or combined pharmacotherapy of lower urinary tract symptoms on the background of benign prostatic hyperplasia in men with erectile dysfunction. However, given the universality and fundamentality of the mechanisms of their pharmacological action (first of all, the effect on the metabolism of one of the key vasomodulators of the vascular bed, nitric oxide NO), the list of potential and promising indications for prescribing these drugs is constantly expanding due to the presence of various «non-classical» (non-erectogenic) effects, which makes them very attractive for wider application not only in urological practice, but also in other medical specialties. The article describes in more detail and purposefully the accumulated to date scientific and practical data on the effectiveness of the use and potential mechanisms of action of sildenafil in cardiology, endocrinology, neurology, nephrology, obstetrics and gynecology, andrological reproductology and oncology, and also presents the results of studies confirming its safety in the treatment of relevant specialized diseases.

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RETRACTED ARTICLE: Utero-placental perfusion Doppler indices in growth restricted fetuses: effect of sildenafil citrate

Abstract: gov Registry: NCT02362399.

Cited by 38 publications

References 18 publications

STRIDER NZAus: a multicentre randomised controlled trial of sildenafil therapy in early‐onset fetal growth restriction

STRIDER NZAus: a multicentre randomised controlled trial of sildenafil therapy in early‐onset fetal growth restriction

Maternal sildenafil for severe fetal growth restriction (STRIDER): a multicentre, randomised, placebo-controlled, double-blind trial

Non-classical effects of sildenafil in clinical medicine: an interdisciplinary approach

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