Sildenafil citrate therapy for severe early-onset intrauterine growth restriction

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Abstract:

Please cite this paper as: von Dadelszen P, Dwinnell S, Magee LA, Carleton BC, Gruslin A, Lee B, Lim KI, Liston RM, Miller SP, Rurak D, Sherlock RL, Skoll MA, Wareing MM, Baker PN, for the Research into Advanced Fetal Diagnosis and Therapy (RAFT) Group. Sildenafil citrate therapy for severe early-onset intrauterine growth restriction. BJOG 2011;118:624–628.

Currently, there is no effective therapy for severe early-onset intrauterine growth restriction (IUGR). Sildenafil citrate vasodilates the myometrial arteries isolated from women with IUGR-complicated pregnancies. Women were offered Sildenafil (25 mg three times daily until delivery) if their pregnancy was complicated by early-onset IUGR [abdominal circumference (AC) < 5th percentile] and either the gestational age was <25+0 weeks or an estimate of the fetal weight was <600 g (excluding known fetal anomaly/syndrome and/or planned termination). Sildenafil treatment was associated with increased fetal AC growth [odds ratio, 12.9; 95% confidence interval (CI), 1.3, 126; compared with institutional Sildenafil-naive early-onset IUGR controls]. Randomised controlled trial data are required to determine whether Sildenafil improves perinatal outcomes for early-onset IUGR-complicated pregnancies.

Keywords: Case-control study; in utero therapy; intrauterine growth restriction; maternal outcomes; perinatal outcomes

Document Type: Short Communication

DOI: http://dx.doi.org/10.1111/j.1471-0528.2010.02879.x

Affiliations: 1: Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada 2: Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, ON, Canada 3: Maternal and Fetal Health Research Group, University of Manchester, Manchester, UK 4: Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada

Publication date: April 1, 2011

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