Kubo Michiko, Umekawa Takashi, Maekawa Yuka, Tanaka Hiroaki, Nii Masafumi, Murabayashi Nao, Osato Kazuhiro, Kamimoto Yuki, Ikeda Tomoaki
Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Japan.
Department of Obstetrics and Gynecology, National Organization Mie Chuo Medical Center, Tsu, Japan.
J Obstet Gynaecol Res. 2017 Feb;43(2):291-297. doi: 10.1111/jog.13218. Epub 2016 Dec 17.
The aim of this retrospective study was to assess tadalafil treatment in pregnant women with fetal growth restriction (FGR) in terms of maternal and perinatal outcomes.
We retrospectively analyzed 11 Japanese singleton pregnant women with FGR who received tadalafil along with conventional management for FGR at Mie University Hospital from July 2015 to February 2016 (tadalafil group). These women were matched for maternal age, parity, gestational age, and estimated fetal weight at enrollment with 14 singleton pregnant women who received only the conventional management for FGR in 2014 (conventional management group). The conventional management for FGR was performed according to guidelines for obstetric practice in Japan.
Both birthweight and fetal growth velocity from enrollment to birth were significantly higher in the tadalafil group than in the conventional management group. The cesarean delivery rate was approximately twofold higher in the conventional management group than in the tadalafil group. Importantly, cesarean section due to non-reassuring fetal status was performed in seven pregnant women in the conventional management group (58.3%) but in none in the tadalafil group (P < 0.05, chi-squared test).
Tadalafil may improve perinatal outcome in FGR by modulating fetal growth through maintenance or improvement of fetal well-being.
本回顾性研究旨在从孕产妇及围产期结局方面评估他达拉非对胎儿生长受限（FGR）孕妇的治疗效果。
我们回顾性分析了2015年7月至2016年2月期间在三重大学医院接受他达拉非治疗并同时接受FGR常规治疗的11例日本单胎FGR孕妇（他达拉非组）。这些孕妇在年龄、产次、孕周及入组时的估计胎儿体重方面与2014年仅接受FGR常规治疗的14例单胎孕妇（常规治疗组）相匹配。FGR的常规治疗按照日本产科实践指南进行。
他达拉非组从入组至分娩的出生体重及胎儿生长速度均显著高于常规治疗组。常规治疗组的剖宫产率约为他达拉非组的两倍。重要的是，常规治疗组有7例孕妇（58.3%）因胎儿状况不佳而行剖宫产，而他达拉非组无1例（P<0.05，卡方检验）。
他达拉非可能通过维持或改善胎儿健康来调节胎儿生长，从而改善FGR的围产期结局。
