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sildenafil in pregnancy

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https://www.readbyqxmd.com/read/29735634/evaluation-of-sildenafil-and-tadalafil-for-reversing-constriction-of-fetal-arteries-in-a-human-placenta-perfusion-model
#1
Robert B Walton, Luckey C Reed, Sarah M Estrada, Stacey S Schmiedecke, Diana L Villazana-Kretzer, Peter G Napolitano, Nicholas Ieronimakis
Fetal growth restriction resulting from reduced placental blood perfusion is a major cause of neonatal morbidity and mortality. Aside from intense surveillance and early delivery, there is no treatment for fetal growth restriction. A potential treatment associated with placental vasoconstriction is the class of PDE5 (phosphodiesterase type 5) inhibitors such as sildenafil, which is known to cross the placenta. In contrast, tadalafil, a more potent and selective PDE5 inhibitor has not been studied in pregnancy or experimental models of fetal growth restriction...
May 7, 2018: Hypertension
https://www.readbyqxmd.com/read/29716434/effect-of-sildenafil-on-pulmonary-circulation-and-cardiovascular-function-in-near-term-fetal-sheep-during-hypoxemia
#2
Amarnath Bhide, Leena Alanne, Juha Rasanen, Heikki Huhta, Juulia Junno, Merja Kokki, Tiina Erkinaro, Pasi Ohtonen, Mervi Haapsamo, Ganesh Acharya
Sildenafil is a potential new treatment for placental insufficiency in human pregnancies as it reduces the breakdown of vasodilator nitric oxide. Pulmonary vasodilatation is observed in normoxemic fetuses following sildenafil administration. Placental insufficiency often leads to fetal hypoxemia that can cause pulmonary vasoconstriction and fetal cardiac dysfunction as evidenced by reduced isovolumic myocardial velocities. We tested the hypotheses that sildenafil, when given directly to the hypoxemic fetus, reverses reactive pulmonary vasoconstriction, increases left ventricular cardiac output by increasing pulmonary venous return, and ameliorates hypoxemic myocardial dysfunction...
January 1, 2018: Reproductive Sciences
https://www.readbyqxmd.com/read/29525197/perioperative-management-of-pregnant-women-with-idiopathic-pulmonary-arterial-hypertension-an-observational-case-series-study-from-china
#3
Jinglan Zhang, Jiakai Lu, Xiaorui Zhou, Xuefeng Xu, Qing Ye, Qitan Ou, Yanna Li, Jiapeng Huang
OBJECTIVES: The mortality of pregnant women with idiopathic pulmonary arterial hypertension (PAH) is very high. There are limited data on the management of idiopathic PAH during pregnancy. The authors aimed to examine systematically the characteristics of parturient women with idiopathic PAH, to explore the adverse effects of idiopathic PAH on pregnancy outcomes, and to report the multidisciplinary perioperative management strategy from the largest comprehensive cardiac hospital in China...
March 7, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29355552/maternal-hypertension-and-feto-placental-growth-restriction-is-reversed-by-sildenafil-evidence-of-independent-effects-of-circulating-nitric-oxide-levels
#4
Victor Hugo Gonçalves-Rizzi, José Sérgio Possomato-Vieira, Regina Aparecida Nascimento, Mayara Caldeira-Dias, Carlos Alan Dias-Junior
Sildenafil has shown nitric oxide (NO)-independent pleiotropic effects, however the mechanisms involved are unclear. We investigated the protective effects of sildenafil against hypertension in pregnancy and feto-placental growth restriction induced by NO inhibition, and if sodium nitrite-derived NO formation influences sildenafil effects. We evaluated the plasmatic levels of NO metabolites, cyclic guanosine monophosphate (cGMP), oxidative stress and myeloperoxidase, which are involved in endothelial dysfunction during hypertension in pregnancy...
March 5, 2018: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29351114/sexual-and-reproductive-issues-and-inflammatory-bowel-disease-a-neglected-topic-in-men
#5
Mariangela Allocca, Daniela Gilardi, Gionata Fiorino, Federica Furfaro, Laurent Peyrin-Biroulet, Silvio Danese
There has been considerable literature on sexual issues in women with inflammatory bowel disease (IBD), but relatively little attention has been paid to these aspects in men. To review the available literature and to provide the best management of sexual and reproductive issues in male patients with IBD. The scientific literature on sexual and reproductive issues in men with IBD was reviewed. Several factors, including surgical and medication treatments, disease activity, lifestyle, and psychological factors, may play a role in the development of infertility and sexual dysfunction and may negatively impact pregnancy outcomes...
March 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29282009/strider-sildenafil-therapy-in-dismal-prognosis-early-onset-fetal-growth-restriction-an-international-consortium-of-randomised-placebo-controlled-trials
#6
A Pels, L C Kenny, Z Alfirevic, P N Baker, Peter von Dadelszen, C Gluud, C T Kariya, B W Mol, A T Papageorghiou, A G van Wassenaer-Leemhuis, W Ganzevoort, K M Groom
BACKGROUND: Severe, early-onset fetal growth restriction due to placental insufficiency is associated with a high risk of perinatal mortality and morbidity with long-lasting sequelae. Placental insufficiency is the result of abnormal formation and function of the placenta with inadequate remodelling of the maternal spiral arteries. There is currently no effective therapy available. Some evidence suggests sildenafil citrate may improve uteroplacental blood flow, fetal growth, and meaningful infant outcomes...
December 28, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29278046/pregnancy-affects-the-pharmacokinetics-of-sildenafil-and-its-metabolite-in-the-rabbit
#7
Francesca M Russo, Paola Mian, Elke H Krekels, Kristel Van Calsteren, Dick Tibboel, Jan Deprest, Karel Allegaert
1. There is growing interest in the use of sildenafil during pregnancy for various maternal and fetal conditions. This study aims to investigate the effect of pregnancy on the maternal pharmacokinetics (PK) of sildenafil and its main metabolite desmethylsildenafil in rabbits. Using NONMEM, population PK modeling was performed based on plasma samples from 31 rabbits of whom 15 were pregnant and 16 were not. All received a single subcutaneous sildenafil dose of 10 mg/kg. One sample was obtained per rabbit at either 30, 60, 120, 360, 720 or 1320 min after sildenafil administration...
January 10, 2018: Xenobiotica; the Fate of Foreign Compounds in Biological Systems
https://www.readbyqxmd.com/read/29229321/the-role-of-aspirin-heparin-and-other-interventions-in-the-prevention-and-treatment-of-fetal-growth-restriction
#8
REVIEW
Katie M Groom, Anna L David
Fetal growth restriction and related placental pathologies such as preeclampsia, stillbirth, and placental abruption are believed to arise in early pregnancy when inadequate remodeling of the maternal spiral arteries leads to persistent high-resistance and low-flow uteroplacental circulation. The consequent placental ischaemia, reperfusion injury, and oxidative stress are associated with an imbalance in angiogenic/antiangiogenic factors. Many interventions have centered on the prevention and/or treatment of preeclampsia with results pertaining to fetal growth restriction and small-for-gestational-age pregnancy often included as secondary outcomes because of the common pathophysiology...
February 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28893896/sildenafil-during-pregnancy-a-preclinical-meta-analysis-on-fetal-growth-and-maternal-blood-pressure
#9
Nina D Paauw, Fieke Terstappen, Wessel Ganzevoort, Jaap A Joles, Hendrik Gremmels, A Titia Lely
Sildenafil is a new approach to treat fetal growth restriction (FGR) and preeclampsia. We performed a systematic meta-analysis to evaluate effects of sildenafil. Our search identified 22 animal studies (mouse, rat, rabbit, sheep, and guinea pigs) and 2 human randomized controlled trials. Data were pooled using ratio of means and mean differences with 95% confidence intervals for fetal growth and maternal blood pressure, respectively. Meta-regression analyses were performed for study-related factors that might affect efficacy of sildenafil, including the model used (healthy pregnancy versus FGR/preeclampsia) and route of administration...
November 2017: Hypertension
https://www.readbyqxmd.com/read/28721181/adding-sildenafil-vaginal-gel-to-clomiphene-citrate-in-infertile-women-with-prior-clomiphene-citrate-failure-due-to-thin-endometrium-a-prospective-self-controlled-clinical-trial
#10
A N Fetih, D M Habib, I I Abdelaal, M Hussein, G N Fetih, E R Othman
We aimed to investigate the effect of adding sildenafil vaginal gel to clomiphene citrate (CC) in infertile women with prior CC failure. METHODS: This is a self- controlled clinical trial. Women with CC failure (in prior 5 cycles) and thin endometrium were recruited (N = 42). In their 6th (CC only) cycle, women continued on CC 100 mg/ day for 5 days, and had measurement of endometrial thickness and Doppler assessment of uterine arteries on day of HCG administration. In the 7th cycle, women (N = 36) were given usual dose of CC supplemented with sildenafil vaginal gel (5 gm, containing 50 mg sildenafil) twice daily from cycle day 8 to day of HCG administration...
March 2017: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/28524032/-preoperative-risk-factors-analysis-of-pulmonary-hypertension-crisis-during-perioperative-period-for-caesarean-section-of-woman-with-severe-pulmonary-hypertension
#11
Chunlei Zhang, Yaguang Liu, Enming Qing, Jun Ma
OBJECTIVE: To analyze preoperative risk factors of perioperative pulmonary hypertension crisis (PHC) for pregnant woman with severe pulmonary artery hypertension (PAH), and approach its clinical value. METHODS: A retrospective analysis was conducted. The clinical data from 152 pregnant women with severe PAH underwent cesarean delivery admitted to Beijing Anzhen Hospital from January 1st 2008 to December 31st 2016 was collected. The patients were divided into two groups according to with perioperative PHC or not...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28345432/utero-placental-perfusion-doppler-indices-in-growth-restricted-fetuses-effect-of-sildenafil-citrate
#12
Mohamed Adel El-Sayed, Said Abdel-Aty Saleh, Mohammad Ahmed Maher, Asmaa Mohamed Khidre
OBJECTIVE: To assess efficacy and tolerability of sildenafil citrate on utero-placental blood flow and fetal growth in pregnancies complicated by fetal growth restriction (FGR). METHODS: From March 2015, a randomized controlled trial of 54 patients at 24 weeks or more complicated by FGR and abnormal Doppler indices were randomly allocated 1:1 into an intervention arm (receive sildenafil citrate, 50 mg) or a control arm (receive placebo). The primary outcomes were changes occurred in the Doppler parameters 2 h following drug administration...
April 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28326740/successful-pregnancy-after-intralipid-addition-to-sildenafil-and-enoxaparin-in-woman-with-history-of-recurrent-pregnancy-loss-rpl
#13
Malgorzata Jerzak, Monika Szafarowska, Monika Kniotek, Andrzej Gorski
OBJECTIVES: Does addition of Intralipid to sildenafil and enoxaparin immunotherapy improve pregnancy outcome? MATERIALS AND METHOD: Report of a striking case of a patient with history of 4 recurrent pregnancy losses (RPL) and IVF failures. RESULTS: Adding of Intralipid resulted in giving birth to a healthy male baby in the 3th IVF cycle. CONCLUSION: Combination therapy that includes Intralipid may generate successful IVF outcome, although this problem merits further study, especially regarding safety issues...
December 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/28277352/sildenafil-citrate-therapy-for-oligohydramnios-a-randomized-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
Mohammad Ahmed Maher, Tarek Mohammad Sayyed, Nabih Elkhouly
OBJECTIVE: To compare sildenafil plus hydration with hydration alone in improving the amniotic fluid index and neonatal outcomes in pregnancies complicated by idiopathic oligohydramnios ( amniotic fluid index less than 5 cm without underlying maternal or fetal causes and with normal fetal growth). METHODS: This was an open-label randomized trial for women carrying singleton pregnancies at 30 weeks of gestation or more with idiopathic oligohydramnios detected during routine ultrasonogram...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27940055/the-effects-of-sildenafil-citrate-on-uterine-angiogenic-status-and-serum-inflammatory-markers-in-an-l-name-rat-model-of-pre-eclampsia
#15
Nerolen Soobryan, Saravanakumar Murugesan, Wendy Phoswa, Prem Gathiram, Jagidesa Moodley, Irene Mackraj
Pre-eclampsia (PE), a hypertensive disorder of pregnancy, is detrimental to both mother and foetus. There is currently no effective treatment, but we have shown that Sildenafil Citrate (SC) improve various foetal outcomes in Nω -nitro-L arginine methyl ester (L-NAME) rat model of PE. Therefore, we aimed to investigate the effects of SC on a uterine angiogenic status and serum inflammatory markers in an L-NAME rat model of PE. One hundred and twenty adult nulliparous pregnant female Sprague-Dawley rats were used for the study...
January 15, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/27926905/sildenafil-in-pregnancy-a-systematic-review-of-maternal-tolerance-and-obstetric-and-perinatal-outcomes
#16
REVIEW
Liam Dunn, Ristan Greer, Vicki Flenady, Sailesh Kumar
INTRODUCTION: This systematic review evaluates maternal tolerance and obstetric and perinatal outcomes following sildenafil citrate (SC) use in human pregnancy. DATA SOURCES: Scopus, PubMed, Cochrane Library, Web of Science, Embase, and Google Scholar were searched. Relevant full-text studies including case series and reports in English were included. Publications were excluded if the pregnancy was terminated or if SC was used only at conception. RESULTS: Sixteen studies were included (n = 165)...
2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/27861916/sildenafil-therapy-for-fetal-cardiovascular-dysfunction-during-hypoxic-development-studies-in-the-chick-embryo
#17
Nozomi Itani, Katie L Skeffington, Christian Beck, Dino A Giussani
KEY POINTS: Common complications of pregnancy, such as chronic fetal hypoxia, trigger a fetal origin of cardiovascular dysfunction and programme cardiovascular disease in later life. Sildenafil treatment protects placental perfusion and fetal growth, but whether the effects of sildenafil transcend the placenta to affect the fetus is unknown. Using the chick embryo model, here we show that sildenafil treatment directly protects the fetal cardiovascular system in hypoxic development, and that the mechanisms of sildenafil protection include reduced oxidative stress and increased nitric oxide bioavailability; Sildenafil does not protect against fetal growth restriction in the chick embryo, supporting the idea that the protective effect of sildenafil on fetal growth reported in mammalian studies, including humans, is secondary to improved placental perfusion...
March 1, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/27821175/early-onset-fetal-growth-restriction-treated-with-the-long-acting-phosphodiesterase-5-inhibitor-tadalafil-a-case-report
#18
Mito Sakamoto, Kazuhiro Osato, Michiko Kubo, Masafumi Nii, Hiroaki Tanaka, Nao Murabayashi, Takashi Umekawa, Yuki Kamimoto, Tomoaki Ikeda
BACKGROUND: Severe early-onset fetal growth restriction occurs in 0.4 % of all pregnancies, and the prognoses of these patients are dismal. Severely growth-restricted fetuses (far below 500 g) are thought to be nonviable. Since there have not been effective treatments for such fetal patients, obstetricians have simply tried to identify the optimal timing for their delivery. There are a few reports suggesting that the phosphodiesterase type 5 inhibitor sildenafil has some limited beneficial effects on fetal growth, but there are no such reports on tadalafil, another derivative phosphodiesterase type 5 inhibitor which has a much longer half-life than sildenafil...
November 8, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27783532/thermosensitive-bioadhesive-gels-for-the-vaginal-delivery-of-sildenafil-citrate-in-vitro-characterization-and-clinical-evaluation-in-women-using-clomiphene-citrate-for-induction-of-ovulation
#19
RANDOMIZED CONTROLLED TRIAL
Ghareb M Soliman, Gihan Fetih, Ahmed M Abbas
OBJECTIVE: The objective of this study is to develop and characterize in situ thermosensitive gels for the vaginal administration of sildenafil as a potential treatment of endometrial thinning occurring as a result of using clomiphene citrate for ovulation induction in women with type II eugonadotrophic anovulation. While sildenafil has shown promising results in the treatment of infertility in women, the lack of vaginal pharmaceutical preparation and the side effects associated with oral sildenafil limit its clinical effectiveness...
March 2017: Drug Development and Industrial Pharmacy
https://www.readbyqxmd.com/read/27645716/ep17-02-the-use-of-sildenafil-citrate-in-pregnancy-a-systematic-review
#20
R Negrini, R D Ferreira, R C Oliveira
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
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