Efficacy of Sildenafil Citrate in induction of Labor Randomized control trial

Abstract

Cervical ripening is commonly stimulated pharmacologically before induction of labor, to reduce the risk of failed induction and of operative delivery. Vaginal low-dose misoprostol (a prostaglandin E1 analogue), is recommended by WHO for induction of labor, and it is the current method of choice used for cervical ripening. In comparison with dinoprostone (a prostaglandin E2 analogue), misoprostol has better efficacy for cervical ripening, which leads to a shorter time from initial dose to delivery and also from initial dose to beginning of the active phase of labor and less need for oxytocin use. However, using prostaglandins is not without adverse maternal and fetal effects, mainly because of their stimulatory effects on uterine contractions, which may result in uterine rupture and fetal. The ideal agent for the induction of cervical ripening should produce adequate cervical change with minimal fetal and maternal side-effects. Many agents have been proposed for inducing labor and cervical ripening such as: oxytocin, corticosteroids, oestrogen and relaxin Sildenafil has not been used as a drug for induction of labor in previous studies. However, due to its vasodilator activity, like its family member nitrates, it could be effective if