Dose Sildenafil Citrate Reduce the Incidence of Emergency Cesarean  Section and Fetal Distress During Labor? A Randomized Double-Blinded  Clinical Trial

Seyedeh Hajar Sharami; Forozan  Milani; Roya Kabodmehri; Misa Naghdipour; Azade Mahmoudi Isaabadi; Zahra  Haghparast Ghadim-Limudahi

doi:10.18502/jri.v25i1.15198

Seyedeh Hajar Sharami Reproductive Health Research Center, Department of Obstetrics and Gynecology, School of Medicine, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
Forozan Milani Reproductive Health Research Center, Department of Obstetrics and Gynecology, School of Medicine, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
Roya Kabodmehri Reproductive Health Research Center, Department of Obstetrics and Gynecology, School of Medicine, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
Misa Naghdipour Reproductive Health Research Center, Department of Obstetrics and Gynecology, School of Medicine, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
Azade Mahmoudi Isaabadi Reproductive Health Research Center, Department of Obstetrics and Gynecology, School of Medicine, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
Zahra Haghparast Ghadim-Limudahi Reproductive Health Research Center, Department of Obstetrics and Gynecology, School of Medicine, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran

DOI: https://doi.org/10.18502/jri.v25i1.15198

Keywords: Cesarean section, Fetal distress, Labor, Sildenafil citrate.

Abstract

Background: Fetal distress (FD) is one of the most frequent causes of emergency cesarean section (CS) due to the insufficient uteroplacental blood supply during labor. There is a theory that Sildenafil citrate (SC) may improve the uteroplacental blood supply and decrease fetal hypoxia and FD.

Methods: In a randomized double-blinded clinical trial, a total of 208 low-risk sub-jects who met our stringent inclusion criteria were randomly assigned into two groups: the Sildenafil citrate group (n=104) and the placebo group (n=104). These participants were referred to our referral gynecology and obstetrics department for delivery between July 2022 to September 2022. The SC group received oral SC at a dose of 50 mg every 6 hr, up to a maximum of three times. The final maternal-fetal-neonatal results were recorded and all data were analyzed using SPSS version 23.

Results: The mean age of mothers was 28.98±5.6 years and 120 cases were primi-gravid (57.7%). Out of a total of 208 pregnant subjects, 168 subjects delivered through normal vaginal delivery (80.8%) and 40 cases underwent emergency CS (19.2%). The number of NVD in Sildenafil group was significantly more than place-bo group (87.5% vs. 74%) and SC decreased the rate of emergency CS to 87.5% (RR=2.46%, 95%CI 1.19-5.08). Also, SC decreased the rate of FD to 53.8% (RR= 2.83%, 95%CI of 1-8.24).

Conclusion: The results showed that SC can effectively decrease the rate of emer-gency CS and FD during labor.