Comparative Study between the Effect of Low Molecular Weight Heparin and Sildenafil Citrate on Intrauterine Growth Restriction

Background: Fetal growth restriction (FGR) is defined as when fetal weight below the 10th percentile for gestational age or two Standard Deviation below the mean weight for gestational age. 
Aim: To assess the impacts of low-molecular-weight heparin (LMWH) and sildenafil citrate on the flow of blood through the placenta, which affects the growth and well-being of the fetus in utero.
Methods: Fifty females with placentally mediated FGR were included in this randomized comparative clinical research, which was conducted between twenty-eight and thirty-five weeks of gestation. Randomly, they have been categorized into 2 groups: Group: Sildenafil (SC) Involved 25 women received Sildenafil 25 milligrams every eight hours (Silden® EIPICO Co.). Also, the LMWH group: involved 25 women who received a single daily dosage of LMWH (tinzaparin) (Innohep® LEO pharmaceutical products) subcutaneously starting at the diagnosis of fetal growth restriction until delivery at Damanhur Medical National Institute between January 2022 and January 2023.
Results: A statistically significant variance was observed within the examined groups according to improvement of umbilical artery PI, umbilical artery resistive index, APGAR 1, APGAR 5, birth weight (BW), prematurity, intraventricular hemorrhage, maternal headache, and maternal flushing. No significant difference was observed within the examined groups regarding assessed fetal weight, gestational age, amniotic fluid index, and abdominal circumference during diagnosis.
Conclusion: LMWH in fetal growth-restricted pregnancies significantly increases neonatal body weight, prolongs gestational age at delivery from randomization to delivery, and enhances fetoplacental blood flow, resulting in fewer maternal and neonatal complications.