American Journal of Obstetrics & Gynecology
Volume 200, Issue 1 , Pages 102.e1-102.e7, January 2009

The effects of sildenafil citrate (Viagra) on uterine blood flow and well being in the intrauterine growth-restricted fetus

  • Suzanne L. Miller, PhD

      Affiliations

    • Monash Immunology and Stem Cell Laboratories, Monash University, Clayton, VIC, Australia
    • Department of Physiology, Monash University, Clayton, VIC, Australia
    • Corresponding Author InformationReprints: Suzanne L. Miller, PhD, Department of Physiology, Building 13F, Monash University, Clayton 3800, VIC, Australia
    • ,
  • Jan M. Loose, BSc

      Affiliations

    • Monash Immunology and Stem Cell Laboratories, Monash University, Clayton, VIC, Australia
    • ,
  • Graham Jenkin, PhD

      Affiliations

    • Monash Immunology and Stem Cell Laboratories, Monash University, Clayton, VIC, Australia
    • ,
  • Euan M. Wallace, MD

      Affiliations

    • Department of Obstetrics and Gynecology Monash Institute of Medical Research, Monash University, Clayton, VIC, Australia

Received 18 April 2008; received in revised form 19 June 2008; accepted 8 August 2008. published online 10 October 2008.

Objective

This study examined whether the type-5 phosphodiesterase inhibitor sildenafil citrate (Viagra; Pfizer, New York, NY) could increase uterine blood flow in intrauterine growth restriction (IUGR), thereby improving fetal oxygenation and well being.

Study Design

In fetal sheep, we induced IUGR at 105-110 days (0.7 gestation) using single umbilical artery ligation (SUAL). In SUAL and control animals, we measured uterine blood flow (UBF) and blood gases before and after sildenafil administration.

Results

SUAL fetuses were hypoxemic compared with controls. Following sildenafil, UBF was significantly decreased in both SUAL and control ewes for ∼40 minutes. In response to sildenafil, pO2 was decreased in SUAL and control fetuses and both groups displayed significant hypotension and tachycardia. At postmortem SUAL fetal body weight was significantly reduced by 23% compared with controls.

Conclusion

Sildenafil does not improve UBF or fetal well being in SUAL-induced IUGR pregnancies and should be used with caution in IUGR and healthy pregnancies because of its detrimental effects on uteroplacental perfusion and on the fetus.

Key words: fetal well being, intrauterine growth restriction, sildenafil citrate

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 30.00 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

 This study was supported in part by a program grant from the National Health and Medical Research Council of Australia (to G.J. and E.M.W.).

 Cite this article as: Miller SL, Loose JM, Jenkin G, et al. The effects of sildenafil citrate (Viagra) on uterine blood flow and well being in the intrauterine growth-restricted fetus. Am J Obstet Gynecol 2009;200:102.e1-102.e7.

PII: S0002-9378(08)00931-9

doi:10.1016/j.ajog.2008.08.029

American Journal of Obstetrics & Gynecology
Volume 200, Issue 1 , Pages 102.e1-102.e7, January 2009

Article Tools

* Image Usage & Resolution