EXPERIENCE IN THE USE OF PDE-5 INHIBITORS (SILDENAFIL) IN THE MANAGEMENT OF SEVERE FETOPLACENTAL INSUFFICIENCY: CASE REPORT
Keywords:
fetoplacental insufficiency, fetal growth restriction syndrome, vasodilation, PDE-5 inhibitors, sildenafil, tadalafil, umbilical arteryAbstract
Fetoplacental insufficiency is a deterioration in nutrition, gas exchange and excretion of fetal waste products, which are caused by a violation of the functional state and structure of the placenta. No matter how advanced modern medicine is, placental insufficiency still remains the main and common cause of high morbidity and mortality in children not only in the antenatal period, but even in the later stages of child development. Sildenafil is a phosphodiesterase-5 (PDE-5) inhibitor that prevents the inactivation of the intracellular second messenger cyclic guanosine monophosphate in vascular smooth muscle cells, which in turn enhances the action of nitric oxide, leading to vasodilation, since nitric oxide stimulates the formation of cGMP in vascular smooth muscle cells. This effect is manifested in the vessels of the uterus. Increased uterine blood flow contributes to an increase in the biophysical parameters of the fetus. Thus, it prolongs the gestation period. The article also presents the experience of using PDE-5 inhibitors in the management of a pregnant woman with severe fetoplacental insufficiency.
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