Role of Sildenafil Citrate Therapy in Early-onset Fetal Growth Restriction

Objective: Fetal growth restriction (FGR) refers to a condition in which a fetus is unable to achieve its genetically determined potential size.The common consequences of FGR are neonatal mortality and neurological and neurodevelopmental delays.In this study, we investigated the use of sildenafil citrate therapy in the management of early-onset FGR.Methods: In this prospective randomized controlled study, women aged 20-35 years with singleton pregnancy with 22-32 weeks gestation age, who were having abdominal circumference (AC) less than the 10th percentile, effective fetal weight (EFW) less than the 10th percentile, or amniotic fluid index (AFI) less than or equal to 7 cm were enrolled in the study after obtaining written informed consent.These patients were randomized according to a computer-generated random numbers table and were divided into two groups, namely, group A and group B. Group A women were treated with sildenafil citrate 25 mg per oral three times daily until delivery.Group B women were not treated with sildenafil.Results: On follow-up, the abdominal circumference growth was significantly higher in group A (p = 0.0001) than in group B. Enrollment to delivery duration was average 64.85 ± 13.86 days in group A and 55.35 ± 16.18 days in group B, which is statistically significant (p = 0.0001).Mean birth weight of babies was 2040.92 ± 478.73 g in group A and 1665.60 ± 464.74 g in group (p = 0.007). Conclusion:Sildenafil therapy 25 mg twice a day from the diagnosis of FGR to delivery was beneficial to pregnant women in terms of increase in fetal AC, fetal weight, and pregnancy duration.Clinical significance: Sildenafil therapy 25 mg twice a day from the diagnosis of FGR to delivery was beneficial to pregnant women with FGR in terms of increase in fetal AC, fetal weight, AFI, and pregnancy duration (gain in intrauterine life).