Doppler Indices of Uterine, Umbilical and Fetal Middle Cerebral Arteries Before and After Sildenafil Citrate and Transdermal Nitroglycerin in Cases Suffering from Intrauterine Growth Restriction

Abstract

Introduction Intrauterine growth restriction (IUGR) is a major cause of perinatal morbidity and mortality. Its diagnosis and treatment constitute one of the most important challenges of present day obstetrics. A drug that could improve maternal and fetal hemodynamics in the setting of early intrauterine growth restriction has potential benefit for at least palliation of this ominous condition. In most instances the etiology of IUGR is unknown. The absence of a uniform etiology may help one understand the existence of the large number of treatments suggested for correcting the problem Patients and methods The objective of this study was to compare the effect of transdermal nitroglycerin and oral Sildenafil citrate on Doppler indices of uterine, umbilical and fetal middle cerebral arteries, and changes in fetal weigh, abdominal circumference and amniotic fluid volume in fifty pregnant women who attended inpatient and outpatient clinics in the department of Obstetrics & Gynecology in Tanta University Hospitals, and suffering from asymmetrical intrauterine growth restriction. Results of the study proved a clear significance of the growing role of transdermal nitroglycerin and Sildenafil citrate for augmenting, feto-placental blood flow in the setting of placental vascular insufficiency and IUGR, as a significant reduction in umbilical artery RI, uterine artery RI in the two groups, also abdominal circumference, AFI and estimated fetal weight were significantly increased after 21 days from treatment. That gives a promising treatment for IUGR patients.