الفهرس 
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Abstract
The aim of our study was to evaluate whether sildenafil citrate drug prolongs gestation in women with preeclampsia and improves maternal and fetal outcomes through potential increase in placental and fetoplacental blood flow.
Our study shows that sildenafil citrate given to women with preeclampsia with a mild feature at an oral dose of 50 mg every 8 hours starting from (24 weeks to 37) weeks gestation.
Grouping: 100 women included in this study were randomly divided into two groups :-
group (A): 50 singleton pregnant women with mild preeclampsia with gestational age 24-33 week received oral 50mg sildenafil citrate every 8 hours.
group (B):50 singleton pregnant women with mild preeclampsia with gestational age 24-33 week did not receive sildenafil citrate.
Regarding arterial blood pressure findings, our results showed that at the start of the study there was no statistical significant difference between both groups regarding systolic (SBP), diastolic (DBP) and mean arterial blood pressure (MAP) with p-value: 0.307, 0.431 and 0.434 respectively. While just before delivery our results showed that there was a statistically significant difference between both groups as regard the same parameters (SBP, DBP and MAP) with p-value: <0.001 for each.
Also, our results showed that at the start of the study there was no statistically significant difference between both groups as regard maternal and fetal heart rate, while just before delivery our results showed that patients who take sildenafil citrate in group (I) were having significantly higher maternal and fetal HR compared to those in group (II).
Regarding medication side effects and tolerance, our results showed that headache was the common presenting side effect (30.0%) followed by gastrointestinal upset (12.0%), hot flushes (6.0%), Dizziness (4.0%) and palpitation (4.0%).
Regarding toleration with headache, our results showed that headache subsided by itself in 60.0% of patients complaining of headache (9/15) while in the other 40.0% headache subsided by using medication.
Doppler evaluation of umbilical, uterine and middle cerebral arteries was done for all patients participating in this study at the start of the study, second visit (two weeks after taking medication) and at time of delivery.
Our results showed that throughout this study doppler indices of both uterine and umbilical arteries of patients in group (I) become significantly lower than those in group (II) while there no significant difference between both groups regarding MCA PI.
Regarding indications of delivery, our results showed that there was no statistically significant difference both groups regarding indications of delivery. Our results were in consistency with Trapani et al., (2016).
Regarding prolongation of pregnancy, our results showed that patients in group (I) who take the medication were having higher gestational ages than those in group (II) but without statistically significant difference.
Regarding maternal and neonatal outcomes, our results showed that neonates of patients in group (I) were having significantly higher birth weight, APGAR scores at 1 and 5 minutes than those in group (2) with p-value: < 0.001 for each. Incidence of preterm delivery was insignificantly higher in group (II) than in group (I) with p-value: 0.191. There was no statistically significant difference between both groups regarding mode of delivery, need for NICU admission and
neonatal deaths. One case of IUFD was reported in group (II) who didn’t take medication while no IUFD was reported in group (I) with no statistically significant difference.
In conclusion, our study showed the safety of the use of sildenafil citrate in addition to alpha methyl dopa in the management of mild pre‑eclampsia. These results, combined with the results of other studies are promising. We need larger studies to support our results.