Sildenafil Citrate Therapy for Oligohydramnios

Maher, Mohamed; Sayyed, Tarek; Elkhouly, Nabih I

doi:10.1097/aog.0000000000001928

Cited by 45 publications

(28 citation statements)

References 10 publications

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“…The population of the selected trials consisted of 598 pregnant women, all with comorbidities, among them 139 with pre-eclampsia [20,21], 275 with intrauterine growth restriction [21,22–25], and 184 with oligohydramnios [26].…”

Section: Resultsmentioning

confidence: 99%

“…All of the pregnant women used oral sildenafil, with doses ranging from 50 mg to 150 mg daily. With the exception of one study [26], all patients used a pill similar to sildenafil as the placebo. The follow-up time of all the studies was from the day of recruitment until birth, except for one study that did not follow up patients until delivery [22].…”

Section: Resultsmentioning

confidence: 99%

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The effects of sildenafil in maternal and fetal outcomes in pregnancy: A systematic review and meta-analysis

et al. 2019

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Background The number of studies associating the use of sildenafil in gestation is increasing. This drug inhibits phosphodiesterase type 5 (PDE5), an enzyme responsible for degradation of nitric oxide, and its efficacy is greater in the placental territory, as the maternal side of the placenta have more PDE5 than other sites. For this reason, promising results have been observed related to the prevention of preeclampsia and intrauterine growth restriction and to improvement of maternal-fetal morbidity in cases of placental insufficiency. Objective To evaluate the benefits of using sildenafil in pregnancy. Searched strategy MEDLINE, ClinicalTrials.gov, Embase, LILACS and Cochrane databases were searched through September 2018. There was no restriction in language or year of publication. This study was registered in PROSPERO (CRD42017060288). Selection criteria Randomized clinical trials which used sildenafil for treatment or prevention of obstetric diseases compared with placebo were selected. Data collection and analysis The results were obtained using the inverse variance method for continuous variables and Man-Whitney for categorical variables. Main results Among a population of 598 pregnant women from the seven clinical trials included, 139 had pre-eclampsia, 275 had intrauterine growth restriction, and 184 had oligohydramnios. A significant increase of 222.58 grams [27.75 to 417.41] was observed in the fetal weight at birth of patients taking sildenafil. The other outcomes did not show any statistical significance. This may be due to the small number of patients used in each study and the great heterogeneity between the groups. Conclusions Sildenafil could be associated with increasing fetal weight at birth in placental insufficiency despite the limitations of this meta-analysis, even though more studies in this field are needed to introduce this drug into obstetric clinical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The effects of sildenafil in maternal and fetal outcomes in pregnancy: A systematic review and meta-analysis

et al. 2019

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“…Firstly, lack of efficacy of sildenafil in FGR does not exclude its efficacy in other conditions. Sildenafil is effective for the treatment of oligohydramnios. Its use during labor to reduce fetal distress is being assessed in an ongoing randomized controlled trial (RIDSTRESS).…”

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confidence: 99%

Antenatal therapy with sildenafil: don't throw the baby out with the bathwater

Russo

Hooper

Tibboel

et al. 2019

Ultrasound in Obstet & Gyne

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“…125 Antenatally, sildenafil has been investigated in randomized controlled trials to determine its effect upon pregnancy duration in women with preeclampsia, 126 and on amniotic fluid volume in pregnancies complicated by idiopathic oligohydramnios. 127 In both trials, no differences in adverse effects between sildenafil and placebo were observed, in either mother or fetus.…”

Section: Safetymentioning

confidence: 90%

Antenatal Medical Therapies to Improve Lung Development in Congenital Diaphragmatic Hernia

et al. 2018

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Congenital diaphragmatic hernia (CDH) is a birth defect characterized by failed closure of the diaphragm, allowing abdominal viscera to herniate into the thoracic cavity and subsequently impair pulmonary and vascular development. Despite improving standardized postnatal management, there remains a population of severe CDH for whom postnatal care falls short. In these severe cases, antenatal surgical intervention (fetoscopic endoluminal tracheal occlusion [FETO]) may improve survival; however, FETO increases the risk of preterm delivery, is not widely offered, and still fails in half of cases. Antenatal medical therapies that stimulate antenatal pulmonary development are therefore interesting alternatives. By presenting the animal research underpinning novel antenatal medical therapies for CDH, and considering the applications of these therapies to clinical practice, this review will explore the future of antenatal CDH management with a focus on the phosphodiesterase-5 inhibitor sildenafil.

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Sildenafil Citrate Therapy for Oligohydramnios

Abstract: ClinicalTrials.gov, www.clinicaltrials.gov, NCT02372487.

Cited by 45 publications

References 10 publications

The effects of sildenafil in maternal and fetal outcomes in pregnancy: A systematic review and meta-analysis

The effects of sildenafil in maternal and fetal outcomes in pregnancy: A systematic review and meta-analysis

Antenatal therapy with sildenafil: don't throw the baby out with the bathwater

Antenatal Medical Therapies to Improve Lung Development in Congenital Diaphragmatic Hernia

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