الفهرس 
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Abstract
Severe intrauterine growth restriction (IUGR) complicates approximately 0.4% of the pregnancies. It increases the risk of perinatal morbidity and mortality. A possible therapeutic strategy for IUGR is the administration of Sildenafil Citrate (SC), a vasodilator molecule that enhances nitric oxide NO concentrations by inhibiting phosphodiesterase-5 (PDE-5) activity, which may optimize placental function and, therefore, alleviate IUGR in at-risk pregnancies.
The current study was designed to evaluate the effectiveness of Sildenafil Citrate in the treatment of intrauterine growth restriction. It was a single group non-randomized clinical trial involving 258 pregnant women suffering from intra uterine growth restriction (IUGR), each of them had been offered to receive (20 mg) of sildenafil citrate three times daily until termination of pregnancy, the study was conducted in the department of obstetrics and gynecology of Beni-Suef University and Beni-Suef General Hospitals.
All included pregnant women underwent fetal Doppler and ultrasound before and four weeks after the Sildenafil administration. The primary outcome measures were (fetal weight, amniotic fluid index, doppler indices).
The results of the current study demonstrated a statistically significant improvement in fetal biometric measures before and four weeks after Sildenafil citrate administration, BPD (biparietal diameter), HC (head circumference), AC (abdominal circumference), FL (femur length), AFI, (Amniotic Fluid Index) and Estimated weight.
Doppler Findings before and four weeks after Sildenafil citrate administration showed a statistically significant improvement in the placental blood flow.
The rate of change in Doppler Findings before and four weeks after Sildenafil citrate administration was calculated.
Cerebral artery blood flow rate of change showed a statistically significant increase, while pulsatory index showed a statistically significant decrease and resistant index showed a statistically significant decrease..
Umbilical artery pulsatory index showed a statistically significant decrease and resistant index showed a statistically significant decrease..
Uterine artery blood flow rate of change showed a statistically significant increase, while pulsatory index showed a statistically significant decrease and resistant index showed a statistically significant decrease.
In conclusion, the results of the current study added to the results of other previous studies are promising regarding the effectiveness of Sildenafil Citrate in the treatment of intrauterine growth restriction. However, studies with a larger number of patients and an earlier start of medication are required. Future evaluation of other phosphodiesterase type 5 inhibitors, particularly if the medication can be safely started earlier and used for a longer period of time, may prove beneficial in the treatment of patients affected by IUGR.