Intrauterine growth restriction in pregnant women can result in problems for both the mother-to-be and the fetus she is carrying.Barely a month goes by without yet another revelation of newly discovered medicinal properties of sildenafil citrate, the active ingredient in Viagra. That versatile little blue pill first came to fame for its ability to help recover erectile function — at least temporarily — for many impotent men.
One of the more recent developments in Viagra research comes in the form of expanded studies into sildenafil’s ability to combat intrauterine growth restriction, or IUGR, in pregnant women. IUGR is a condition in which fetal development in the womb of a mother-to-be is slower than normal. Left untreated, IUGR increases the risk of several health problems that can occur during pregnancy, delivery, and/or after birth.
IUGR-Related Complications
According to WebMD, such health problems include low birth weight for the newborn, difficulties in handling the stress of vaginal delivery, low blood sugar, decreased oxygen levels, lowered resistance to infection, trouble maintaining normal body temperature, and abnormally high red blood cell counts. IUGR can also result in premature delivery and stillbirth.
Although earlier studies — mostly in-vitro and animal testing — have indicated that sildenafil could help to counteract the effects of IUGR, more researchers are jumping on the bandwagon to learn more about the drug’s effects in treating this widespread condition. In late May 2015, Louise Kenney, M.D., founding director of the Irish Centre for Fetal and Neonatal Translational (INFANT) Research announced that the Cork-based research center would begin clinical testing in an effort to definitively prove sildenafil’s efficacy and safety for treating IUGR.
Much Data Already Collected
Dr. Kenney, who is also a professor of obstetrics at University College Cork, acknowledged that over the last two decades, a prodigious amount of data has been collected regarding the safety of sildenafil when administered during pregnancy. She noted that the drug “has even been given on a compassionate basis to some mothers whose babies are small, and it has been found to work well.”
Clinical testing, such as is planned at INFANT, hopefully will produce definitive proof of sildenafil’s safety and effectiveness as a treatment for IUGR. “If this treatment works, it will be the first of its kind, as currently there is no treatment for small babies in the womb,” said Dr. Kenney. “All doctors can do now is monitor mother and baby and see when is best to deliver, which generally means the baby will be premature.”
Many infants born to mothers with IUGR suffer from low birth weight and may be born prematurely.Worldwide, restricted fetal growth in the womb is a widespread problem, occurring in 3 to 10 percent of all babies, according to Dr. Kenney. Among the adverse results of restricted fetal growth in the womb are “babies that are very small being born early.” And low birth weight babies who survive into adulthood are at increased risk of health problems, such as type 2 diabetes.
Other Studies Underway
The Irish clinical study on sildenafil’s potential as a treatment for IUGR is just one of many under way at research centers around the world. Perhaps the first such clinical study encompassing research centers in both Australia and New Zealand was launched in mid-2013. That three-year study, still ongoing, is seeking to answer two basic questions: (1) Does sildenafil increase fetal growth velocity, or the pace at which the fetus develops in the womb? (2) Can sildenafil improve the rate of neonatal survival?
Although the two-country study will be conducted at medical centers in major cities in Australia and New Zealand, it will be directed by Katie Groom, M.D., a senior lecturer in the Department of Obstetrics and Gynecology at the University of Auckland in New Zealand. All participating research centers will report their findings to Dr. Groom. Medical centers participating in the three-year study are located in the Australian cities of Adelaide, Brisbane, Melbourne, Perth, and Sydney, as well as Auckland, Christchurch, and Wellington in New Zealand.
Sildenafil and Pre-eclampsia
Another condition that can adversely affect the outcome of a pregnancy is pre-eclampsia, which is a complication characterized by high blood pressure and indications of damage to another organ system, often the kidneys, according to MayoClinic.com. Although research studies seems to indicate that it is an independent biologic condition, pre-eclampsia is quite often seen in women who are also suffering from IUGR. Although IUGR can pop up at varying times during the term of a pregnancy, pre-eclampsia rarely occurs before the 20th week of pregnancy.
Although the outward symptoms of pre-eclampsia are sometimes nonexistent or so mild that they go unnoticed, such symptoms can include severe headaches, vision changes, upper abdominal pain, decreased urine output, high protein levels in the urine, and shortness of breath.
Left untreated, pre-eclampsia poses a serious threat to both the mother-to-be and her fetus. Traditionally, the primary treatment for pre-eclampsia has been the prompt delivery of the baby, which itself poses significant risks if the fetus has not had sufficient time to develop such that it can survive after delivery.
Preliminary studies have produced evidence that sildenafil citrate, the active ingredient in Viagra, may help counteract the effects of IUGR and pre-eclampsia.Insufficient Blood Flow Blamed
Insufficient blood flow to the uterus and placenta has been implicated as the primary cause of IUGR and pre-eclampsia, which is the reason that researchers have been looking at the effects of sildenafil citrate as a viable treatment for these conditions.
Sildenafil citrate in the form of Viagra was the first of the drugs approved for treatment of impotence caused by compromised blood flow to the penis, which is the largest single cause of erection problems. Sildenafil and the other impotence drugs that have since been introduced all belong to a family of drugs known as PDE5 inhibitors, so-called because they temporarily disable the phosphodiesterase-5 enzyme which tends to restrict blood flow. Thus, sildenafil and the other drugs in its family are vasodilators, meaning that they promote strong blood flow, at least for the period of time the drug is active in the body.
Sildenafil’s ability to optimize blood flow is the primary reason that researchers have looked at its potential in treating IUGR and pre-eclampsia, both of which appear to be caused by insufficient blood flow to the uterus and placenta in pregnant women.
Animal Studies Promising
Researchers at the University of Mississippi Medical Center’s Department of Pharmacology and Toxicology in April 2015 published the results of an animal study of sildenafil’s effects on pregnant rats with pre-eclampsia. They found that treatment with sildenafil normalized uterine artery blood flow in pregnant rats and improved fetal outcomes. The Mississippi research team published their findings in the April 2015 issue of “The FASEB Journal,” the official publication of the Federation of American Societies for Experimental Biology.
Further evidence of the drug’s potential as a treatment for pre-eclampsia came in an Argentine animal study that was published in the May 2015 issue of “Reproduction in Domestic Animals.” In the conclusion to the study, researchers said sildenafil’s ability to successfully treat pre-eclampsia in animals without adverse effects provides the basis for more extensive research into the use of the drug as a pre-eclampsia treatment.
Don Amerman is a freelance author who writes extensively about a wide array of nutrition and health-related topics.
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