Dose Sildenafil Citrate Reduce the Incidence of Emergency Cesarean Section and Fetal Distress During Labor? A Randomized Double-Blinded Clinical Trial

Background: fetal distress (fd) is one of the most frequent causes of emergency cesarean section (cs) due to the insufficient uteroplacental blood supply during labor. there is a theory that sildenafil citrate (sc) may improve the uteroplacental blood supply and decrease fetal hypoxia and fd. methods: in a randomized double-blinded clinical trial, a total of 208 low-risk subjects who met our stringent inclusion criteria were randomly assigned into two groups: the sildenafil citrate group (n=104) and the placebo group (n=104). these participants were referred to our referral gynecology and obstetrics department for delivery between july 2022 to september 2022. the sc group received oral sc at a dose of 50 mg every 6 hr, up to a maximum of three times. the final maternal-fetalneonatal results were recorded and all data were analyzed using spss version 23. results: the mean age of mothers was 28.98±5.6 years and 120 cases were primigravid (57.7%). out of a total of 208 pregnant subjects, 168 subjects delivered through normal vaginal delivery (80.8%) and 40 cases underwent emergency cs (19.2%). the number of nvd in sildenafil group was significantly more than placebo group (87.5% vs. 74%) and sc decreased the rate of emergency cs to 87.5% (rr=2.46%, 95%ci 1.19-5.08). also, sc decreased the rate of fd to 53.8% (rr= 2.83%, 95%ci of 1-8.24). conclusion: the results showed that sc can effectively decrease the rate of emergency cs and fd during labor.