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Background: Foetal growth restriction is an undesirable and challenging diagnosis given the dire foetal and neonatal consequences it is associated with. Ultrasound doppler velocimetry is a surveillance tool in such pregnancies as it illustrates foetal perfusion and nutrient availability. Materials & Methods: The study was conducted as a double blind placebo controlled randomized trial with 37 patients in study group who were administered Sildenafil 25mg TID and 56 patients in control group who were administered a similar placebo. Velocimetry indices in umbilical artery and middle cerebral artery were calculated at eligibility and one week post initiation of intervention. Differences in Sildenafil treated and Sildenafil naïve groups were analysed statistically. Secondary outcomes in terms of side effects were observed and analysed. Results: Sildenafil treated foetuses showed significantly higher decrease in RI (P-0.0003), PI (P-0.04) and S/D(P-0.008) in umbilical artery compared to control group. They also showed -15.115%, -5.526% and 17.009% decrease in RI, PI and S/D respectively post eligibility in study group compared to -1.175%, -1.056% and -6.134% decrease in control group. Middle cerebral artery velocimetry showed a higher increase in RI (+17.204% vs. +7.355%), PI (+25.657% vs. +1.055%), S/D (+27.745% vs. +3.353%) in study vs. control group from eligibility to determination of effect. A significantly higher increase was also seen at determination in study group compared to control group with P values of 0.0002, 0.009 and 0.04 respectively for RI, PI and S/D. Conclusions: Sildenafil appears to significantly normalize ultrasound doppler velocimetry indices in foetuses affectted with late onset restriction.

iosr journal of dental and medical sciences

Sildenafil Citrate Improves Ultrasound Doppler Velocimetry Indices in Foetal Growth Restriction – A Randomised Controlled Trial At A Tertiary Care Teaching Hospital in South India.