Evaluation of the effect of sildenafil citrate in pre-eclampsia

ABSTRACT

This study was undertaken to evaluate the effect of Sildenafil citrate [Viagra] on clinical course, biochemical parameters as well as Doppler ultrasound indices in cases of mild pregnancy-induced hypertension [PIH] and to evaluate the role of Sildenafil, if any, as a new therapeutic modality in mild PIH. The present study was conducted on 60 mild pre-eclamptic pregnant women; they were divided into 2 groups Group I included 40 cases and were subdivided into 2 subgroups Group I A [20 cases] received 100mg sildenafil citrate in 2 daily divided doses for 1 week Group IB [20 cases] received 100 mg sildenafil citrate in 2 daily divided doses for 2 weeks Group II [control] included 20 cases and were subjected to placebo [iron preparation] and bed rest for 1 week. Both groups were subjected to clinical, biochemical and Doppler ultrasound to assess the changes in blood pressure, uric acid, serum creatinine, serum proteins, serum albumin, ultrasound assessment of amniotic fluid index [AFI] and Doppler ultrasound indices [RI, Pl, S/D ratio] respectively before and after the treatment. The study revealed that there was significant decrease in systolic and diastolic blood pressure measurements and all Doppler indices after the use of 100 mg sildenafil for 1 week in group I A and a more significant reduction after longer duration of treatment in group IB without significant change of all these parameters in group II that was subjected to placebo and bed rest for 1 week. Such discussion is still controversial; the subject is still open for much future validation on larger study groups. It is too early for such preliminary study to arrive at sharp conclusions regarding the clinical utility of sildenafil for amelioration of pregnancy-induced hypertension. However it is convenient to report that at least in the current series, significant lowering of blood pressure and improvement of blood flow indices by Doppler ultrasound was attained by 100 mg sildenafil citrate- The possibility of cumulative effect is still hopeful based on more marked effect of the drug with longer duration of administration