RESUMEN
Background: Severe intrauterine growth restriction complicates approximately 0.4% of the pregnancies. It increases the risk of perinatal morbidity and mortality.Subjects and methods: A double blind placebo controlled trial was conducted in Beni Suef University hospitals during 2017. It included 46 pregnant women with severe intrauterine growth restriction. Women were randomly allocated into two groups each included 23 patients. Intervention group received sildenafil citrate 20 mg orally three times a day, in addition to fish oil and zinc supplementation. Control group received tablets similar to sildenafil and the same treatment as intervention group. Primary outcomes included improvement in umbilical and middle cerebral arteries pulsatility indices and abdominal circumference.Results: Umbilical and middle cerebral arteries Doppler indices showed significant difference between groups after intake of sildenafil. Umbilical artery pulsatility index decreased significantly (p value = .001) while middle cerebral artery pulsatility index increased significantly in intervention group (p value0.001). Moreover, abdominal circumference growth velocity improved after two weeks of sildenafil intake (p value = .001).Conclusions: Sildenafil citrate may improve uteroplacental and fetal cerebral perfusion in pregnancies complicated by severe intrauterine growth restriction. It also improves abdominal circumference growth velocity. A wide scale randomized trials are needed for evaluation of neonatal and long term morbidity and mortality outcomes of pregnancies treated by sildenafil citrate.
Asunto(s)
Retardo del Crecimiento Fetal/tratamiento farmacológico , Citrato de Sildenafil/administración & dosificación , Vasodilatadores/administración & dosificación , Administración Oral , Adulto , Peso al Nacer , Método Doble Ciego , Egipto , Femenino , Aceites de Pescado/uso terapéutico , Humanos , Recién Nacido , Arteria Cerebral Media/diagnóstico por imagen , Arteria Cerebral Media/efectos de los fármacos , Placenta/irrigación sanguínea , Placenta/efectos de los fármacos , Embarazo , Flujo Pulsátil , Citrato de Sildenafil/efectos adversos , Ultrasonografía Prenatal , Arterias Umbilicales/diagnóstico por imagen , Arterias Umbilicales/efectos de los fármacos , Vasodilatadores/efectos adversos , Zinc/administración & dosificaciónRESUMEN
This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the Editorial Board for the following reason: This single-author publication which reports the conducting of a large 3-arm randomised controlled trial, with no missing data from 210 recruited patients, has been questioned as implausible. The authors have been unable to provide supporting documents to provide an explanation.