Tanaka Hiroaki, Kubo Michiko, Nii Masafumi, Maki Sintarou, Umekawa Takashi, Ikeda Tomoaki
Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan.
J Obstet Gynaecol Res. 2017 Jul;43(7):1205-1208. doi: 10.1111/jog.13335. Epub 2017 May 15.
For severe pre-eclampsia (PE) with fetal growth restriction (FGR), the only effective treatment is early delivery of the placenta. Clinicians are often forced to end the pregnancy because of maternal indications. We report a case of severe PE with FGR in which the PE was temporarily improved and pregnancy successfully prolonged with tadalafil, a phosphodiesterase 5 inhibitor. A 35-year-old primigravid woman presented at 27 3/7 weeks of gestation with severe PE and FGR. After commencing tadalafil administration, biochemical and angiogenic markers improved. Thereafter, hypertension and proteinuria temporarily improved. Importantly, the pregnancy was prolonged by 14 days after the initiation of tadalafil administration. Tadalafil may be a novel treatment for severe PE with FGR to prolong pregnancy.
对于伴有胎儿生长受限（FGR）的重度子痫前期（PE），唯一有效的治疗方法是尽早娩出胎盘。由于母体指征，临床医生常常被迫终止妊娠。我们报告一例伴有FGR的重度PE病例，使用磷酸二酯酶5抑制剂他达拉非后，子痫前期得到暂时改善，妊娠得以成功延长。一名35岁初孕妇在妊娠27 3/7周时出现重度PE和FGR。开始使用他达拉非后，生化和血管生成标志物有所改善。此后，高血压和蛋白尿暂时改善。重要的是，开始使用他达拉非后，妊娠延长了14天。他达拉非可能是一种用于伴有FGR的重度PE以延长妊娠的新疗法。
