The Effect of Sildenafil on Pregnancy Outcomes in Pregnant Women with Idiopathic Borderline Oligohydramnios: A Randomized Controlled Trial

Dastjerdi, Marzieh Vahid; Ghahghaei-Nezamabadi, Akram; Tehranian, Afsaneh; Mesgaran, Mahbobeh

doi:10.18502/jfrh.v16i2.9482

Cited by 4 publications

(6 citation statements)

References 24 publications

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“…The presence of HDs, characterized by a decrease in serum vascular endothelial growth factor and placental growth factor levels, alongside an increase in soluble fms-like tyrosine kinase-1 levels, may reflect underlying placental dysfunction and are related to inhibition in fetal growth and development 37 38. Oligohydramnios, often seen in conjunction with HDs,39 may indicate complicated pregnancies, signifying chronic suboptimal placental function 40. Such conditions could reduce fetal resources and are associated with SGA.…”

Section: Discussionmentioning

confidence: 99%

“… 37 38 Oligohydramnios, often seen in conjunction with HDs, 39 may indicate complicated pregnancies, signifying chronic suboptimal placental function. 40 Such conditions could reduce fetal resources and are associated with SGA. Thus, maternal blood pressure should be closely monitored and regular ultrasound examinations should be performed to assess changes in pregnancy status.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors and glycaemic control in small-for-gestational-age infants born to mothers with gestational diabetes mellitus: a case–control study using propensity score matching based on a large population

Li,

Pan,

Zheng

et al. 2024

BMJ Open

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BackgroundSmall for gestational age (SGA) poses a significant concern for newborns, being linked to neonatal complications and potential metabolic disorders in adulthood, especially when born to mothers with gestational diabetes mellitus (GDM), elevating their risk of complications and mortality. However, the pregnancy risk factors and glycaemic control associated with SGA infants born to mothers with GDM remain unclear.AimTo identify the pregnancy risk factors and glycaemic control associated with SGA infants born to mothers with GDM.MethodThis case–control study was conducted among 1910 women with GDM in China. Data were collected by the integrated electronic medical record system. Using 1:4 propensity score matching analysis, we adjusted for gestational age as confounder. Univariate and multivariate analyses were performed to identify risk factors.ResultsRisk factors for SGA born to mothers with GDM included a history of low birth weight, gestational hypertension, oligohydramnios, short maternal height, underweight pre-pregnancy body mass index and inadequate weight growth. While SGA was protected by weakly positive ketonuria levels in the first trimester, multiparous, anaemia and previous uterine scar were protective factors for SGA. Moreover, 2-hour postprandial glucose and haemoglobin A1c in the second trimester, as well as the 0-hour and 2-hour 75 g oral glucose tolerance test (OGTT) were linked to risk of SGA.ConclusionsSGA infants are the result of multifactorial interactions among GDM pregnant women. Notably, glycaemic control levels were associated with SGA. There is a need for enhanced perinatal monitoring and antenatal care to reduce SGA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk factors and glycaemic control in small-for-gestational-age infants born to mothers with gestational diabetes mellitus: a case–control study using propensity score matching based on a large population

Li,

Pan,

Zheng

et al. 2024

BMJ Open

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“…Improved outcomes were noted when the treatment approach involved a combination of intravenous hydration for 1 day and oral hydration for at least 14 days with hypotonic fluids [8]. A randomized controlled study by Vahid Dastjerdi et al [6] compared the effectiveness of fluid therapy versus fluid therapy and sildenafil administered during 6 weeks in women with borderline oligohydramnios. After the intervention, no change in AFI was found, nor did pregnancy outcomes differ between the arms of the study.…”

Section: Discussionmentioning

confidence: 99%

“…A few investigational therapies have aimed to increase amniotic fluid volume, by means of maternal hydration, serial amnioinfusion, and administration of sildenafil citrate [4][5][6][7]. Maternal oral hydration has demonstrated more effectiveness than intravenous hydration, and hypotonic solutions have shown superiority to isotonic solutions [4].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Maternal Lower Limb Compression on Amniotic Fluid Index, Uteroplacental Perfusion, and Fetal Blood Flow in Isolated Oligohydramnios

Sgayer,

Frank Wolf,

Mustafa Mikhail

et al. 2023

Fetal Diagn Ther

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Introduction: The aim of this study was to examine the efficacy of pneumatic compression of the maternal lower extremities in increasing the amniotic fluid index (AFI) in pregnancies complicated by isolated oligohydramnios. Methods: Women with isolated oligohydramnios (AFI <5 cm) at 32–41 weeks of pregnancy were connected to a sequential compression device for 60 min. Prior and after the application, AFI and the pulsatility index (PI) of a number of arteries were measured. Results: The median (interquartile range) maternal age of the 21 women included was 29 years (26.50–32.00), the median parity was 1 (1–2), and the median gestational age at intervention was 37.60 weeks (37.00–39.40). The median AFI increased after the application from 4.00 (3.62–4.50) to 6.08 cm (4.90–7.03) (p < 0.001). The median PI of the fetal renal artery decreased from 2.30 (2.01–2.88) to 2.26 (1.68–2.71) (p = 0.01). The hourly fetal urine production did not increase. Changes were not significant in the PI of the umbilical artery, the middle cerebral artery, and the bilateral uterine arteries. Conclusion: Short-term activation of pneumatic compression on maternal lower extremities could increase the AFI in women with isolated oligohydramnios.

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“…The incidence rate of oligohydramnios varies from 0.5 to 5% depending on the studied population and its definition ( 12 ). The average incidence of borderline oligohydramnios in term pregnancy is about 12% ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Perinatal Outcomes in Pregnant Women With Low Amniotic Fluid Index

Milani,

Khosousi,

Sharami

et al. 2023

JFRH

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Objective: The outcomes and management of low amniotic fluid index (AFI) in pregnancy are controversial. The purpose of this study was to determine the relationship between low AFI and perinatal outcomes. Materials and methods: This prospective study was conducted on 420 uncomplicated singleton pregnant women with a gestational age of over 28 weeks who referred to Al-Zahra Hospital in Rasht (Iran) for routine perinatal care. Pregnant women were divided into 3 groups of 140 patients based on the AFI and were followed up until delivery. Three groups included normal (8<AFI≤25 cm(, borderline )5<AFI≤8 cm( and oligohydramnios (AFI≤5cm( AFI. Results: The three adverse outcomes of respiratory distress, hospitalization in NICU, and length of hospitalization were statistically significantly different between the two groups with normal and borderline AFI and in the borderline group was more than the normal group. Adverse outcomes including; low birth weight (LBW), small for gestational age (SGA), respiratory distress, 1- min APGAR scores<7, hospitalization in NICU and its duration were statistically significantly different between the two groups with normal AFI and oligohydramnios, and it was more in the oligohydramnios group than the normal group. The three adverse outcomes of LBW, SGA and1- min APGAR scores<7 in the two borderline and oligohydramnios groups had statistically significant differences and were more in the oligohydramnios group than the borderline group. Conclusion: Consideration to the AFI in perinatal care to predict adverse perinatal outcomes and perform necessary interventions to improve these outcomes is necessary.

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The Effect of Sildenafil on Pregnancy Outcomes in Pregnant Women with Idiopathic Borderline Oligohydramnios: A Randomized Controlled Trial

Cited by 4 publications

References 24 publications

Risk factors and glycaemic control in small-for-gestational-age infants born to mothers with gestational diabetes mellitus: a case–control study using propensity score matching based on a large population

Risk factors and glycaemic control in small-for-gestational-age infants born to mothers with gestational diabetes mellitus: a case–control study using propensity score matching based on a large population

The Effect of Maternal Lower Limb Compression on Amniotic Fluid Index, Uteroplacental Perfusion, and Fetal Blood Flow in Isolated Oligohydramnios

Evaluation of Perinatal Outcomes in Pregnant Women With Low Amniotic Fluid Index

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