en Clinical Medicine Clinical Medicine مقاله مروری Review Article <p style="direction: ltr; text-align: justify;"><span style="font-size:16px;"><span style="font-family:Times New Roman;"><strong><span style="background:#2D7F8F;"><span style="color:white;">&nbsp;Background & Objective:</span></span></strong> &nbsp;<span style="color: black;">Sildenafil citrate is a potential new strategy for the management of intrauterine growth restriction (IUGR) and preeclampsia, although its efficacy still needs to be approved. Accordingly, the aim of this study was to systematically assess the effectiveness of sildenafil on improving fetal Doppler indices, as well as the most common adverse effects of sildenafil.</span></span></span><br> <span style="font-size:16px;"><span style="font-family:Times New Roman;"><strong><span style="letter-spacing:-.1pt;background:#2D7F8F;"><span style="color:white;">&nbsp;Materials & Methods:</span></span> </strong>&nbsp;<span style="letter-spacing: -0.1pt;"><span style="color:black;">Online databases, i.e., PubMed, Web of Science, Scopus, Embase, and Cochrane Reviews, were searched from their date of creation up to 26 Jan 2019. We conducted two meta-analyses, one for fetal Doppler indices and the other for adverse events of sildenafil. Eligible studies were randomized controlled trials (RCTs), in which the effects of sildenafil on fetal Doppler indices have been evaluated. The quality of studies was appraised through the five components of the Cochrane checklist (for quality appraisal of RCT studies) by two of the authors.</span></span></span></span><br> <span style="font-size:16px;"><span style="font-family:Times New Roman;"><strong><span style="background:#2D7F8F;"><span style="color:white;">&nbsp;Results: </span></span>&nbsp;</strong><span style="letter-spacing: -0.1pt;"><span style="color:black;">Out of 1,087 reviewed sources, seven studies were included for meta-analysis. The following results were observed for the effect of sildenafil on the umbilical artery (UA): A significant effect on the umbilical artery pulsatility index (UA PI) (<em>P</em>=0.03) was observed in dosages more than 60 mg/d (<em>P</em>=0.008). Sildenafil was effective in UA PI of the individuals suffering from eclampsia (<em>P</em>=0.008); however, no significant effect was observed on IUGR disorder. Furthermore, sildenafil had no effect on the umbilical artery systolic/diastolic (UA S/D) ratio. Sildenafil was not effective on the middle cerebral artery pulsatility index (MCA PI) or on the middle cerebral artery systolic/diastolic (MCA S/D) ratio. Regarding adverse events, headaches occurred significantly more in mothers consuming sildenafil (P=0.03).&nbsp;</span></span></span></span><br> <span style="font-size:16px;"><span style="font-family:Times New Roman;"><strong><span style="background:#2D7F8F;"><span style="color:white;">&nbsp;Conclusion: </span></span></strong>&nbsp;<span style="color: black;">Obviously, we need more accurate RCTs in this issue before any decision can be made.</span></span></span></p> <p><div style="text-align: justify;"></div></p> <p><div style="text-align: justify;"></div></p> <p><div style="text-align: justify;"></div></p> Sildenafil, Doppler indices, Intrauterine growth restriction, Preeclampsia, Meta-analysis 307 315 http://journal.zums.ac.ir/browse.php?a_code=A-10-5404-1&slc_lang=en&sid=1 Maryam Damghanian Maryamdamghanian@gmail.com 5200319475328460088780 5200319475328460088780 No Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran Farnaz Farnam Fz.farnam@gmail.com 5200319475328460088781 5200319475328460088781 No Dept. of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran Roghieh Kharaghani R.kharaghani@zums.ac.ir 5200319475328460088782 5200319475328460088782 Yes Dept. of Midwifery, School of Nursing and Midwifery. Zanjan University of Medical Sciences, Zanjan, Iran