Sildenafil citrate for the treatment of asymmetrical intrauterine growth restriction: A randomized controlled trial

Abstract

One of the most challenging areas currently facing obstetricians is the detection and management of pregnancies with poor fetal growth. These fetuses experience not only increased rates of perinatal morbidity and mortality, but also higher levels of morbidity extending into adult life. IUGR refers to a fetus that has not reached its growth potential because of genetic or environmental factors that can result in a small for gestational age fetus defined as fetus with AC or EFW below the 10th percentile for gestational age. FGR complicates approximately 0.4% of pregnancies, in which it severely increases the risk of perinatal morbidity and mortality. This is particularly due to premature delivery, both for fetal and for secondary maternal indications such as the development of pre-eclampsia. Low-dose aspirin (150 mg per day) as a treatment for IUGR has been studied over the past several years. One study found that when aspirin was given to women in the third trimester who had abnormal umbilical Doppler indices, fetal weight and head circumference parameters were improved compared with a placebo group (Trudinger et al., 1988).