effect of sildenafil on fetal heart rate pattern during labor

Aims: fetal heart rate patterns are monitored throughout pregnancy and labor to evaluate the health of the fetus. we aimed to evaluate the impact of sildenafil on fetal heart rate patterns during delivery.materials & methods: this single-blind randomized controlled trial was conducted on 198 participants in the maternity unit of imam sajjad hospital, yasuj, in 2024. in addition to standard practices during labor, the intervention group received oral sildenafil at a dose of 50mg every 8 hours, not exceeding 150mg, starting with the initial dose at the onset of the study. in the control group, standard routine care was implemented. the primary outcome measure was fetal heart rate patterns, while the secondary outcome measures included labor duration, meconium-stained amniotic fluid, delivery method, postpartum hemorrhage, apgar score, admission to the neonatal intensive care unit, and adverse effects.findings: ninety-six cases in the sildenafil group and 102 cases in the control group were included in the analysis. the reassuring fetal heart rate pattern was more common in the sildenafil group (80.2% vs. 56.9%). among the various non-reassuring fetal heart rate patterns, tachycardia and bradycardia were more prevalent in the control group than in the sildenafil group. cesarean sections occurred more frequently in the control group than in the sildenafil group. the neonatal outcomes were similar in both groups, and no side effects were reported.conclusion: sildenafil improves non-reassuring fetal heart rate patterns, especially tachycardia and bradycardia, and decreases the rate of cesarean deliveries.