Difference between Oral Isosorbide Mononitrate & Sildenafil Citrate Therapy in Reducing Umbilical Artery Doppler Indices in Pregnancies with Fetal Growth Restriction; A Prospective Randomized Control Trial

Authors

Obstetrics and Gynaecology Department, Faculty of Medicine, Ain shams University, Cairo, Egypt

Abstract

Background: Fetal growth restriction (FGR) occurs when a fetus does not attain its genetically assigned expected growth rate. An estimated fetal weight (EFW) or abdominal circumference (AC) below the 10th percentile for gestational age is the ideal definition of this condition.
Objectives: This study aimed to compare isosorbide mononitrate and sildenafil citrate therapies in the context of pregnancies complicated by FGR regarding the magnitude of reduction in umbilical artery (UA) Doppler resistance index (RI) in a randomized fashion.
Patients and Methods: This research was carried out in the Maternity Hospital of Ain Shams University during the period from March to September 2020. 64 pregnant women with FGR, were recruited from the antenatal clinic. They were subdivided into 2 groups according to a randomization table (Isosorbide mononitrate group versus sildenafil citrate group).
Results: The administration of isosorbide mononitrate 30 mg twice daily is as effective as sildenafil citrate 50 mg twice daily in reducing umbilical artery Doppler resistance index (RI), thereby enhancing fetal growth in pregnancies with FGR and in turn reducing the overall perinatal morbidity and mortality caused by iatrogenic prematurity or FGR itself.
Conclusion: We recommend the use of isosorbide mononitrate as a therapeutic agent in pregnancies with FGR caused by placental insufficiency.
The Egyptian Journal of Hospital Medicine
Volume 88, Issue 1
July 2022
Pages 2958-2963

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