الفهرس 
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Abstract
Pre-eclampsia and eclampsia stand as major causes of maternal and perinatal morbidity and mortality worldwide. However, Mild pre-eclampsia (pre-eclampsia without severity features) represents 75% of cases with pre-eclampsia, possible progression to severe pre-eclampsia makes mild pre-eclampsia a serious problem that requires attention .
The rationale behind using sildenafil citrate in the management of pre-eclampsia is the vasodilatory action of sildenafil that resembles the action of NO, which is a potent vasodilator, especially for the venules, besides being an inhibitor of platelet aggregation
We have done randomized controlled trial (RCT) to To investigate if the use of sildenafil citrate in cases with mild pre-eclampsia can be useful in pregnancy prolongation through prevention of its progression to severe pre-eclampsia and if it would improve maternal and perinatal outcomes.
A total of of 60 women which were randomly assigned to 2 groups:
1. Study group (Sildenafil group): We offered Sildenafil citrate (Respatio® 20mg tablets orally three times daily until delivery) as innovative therapy to 30 women with PIH in addition to alpha methyl dopa.
2. Placebo group: We offered placebo which is a vitamin the same in shape and texture in addition to alpha methyldopa “Aldomet™ 250 mg tablets” to 30 women with PIH.
Recruited patients were thoroughly evaluated with full clinical examination and ultrasound assessment for: fetal viability, placental site, Biparietal diameter, Femur length, abdominal circumference (us-ing Hadlock formulas), amniotic fluid: By calculating the amniotic fluid index measured by the four-quadrant technique and Doppler ul-trasound assessment of the uterine, umbilical and middle cerebral ar-teries: pulsatility (PI), resistance (RI) indices .
Our study shows that sildenafil citrate showed better control of blood pressure (systolic – diastolic).
There was no statistical significance in umbilical artery and MCA pulsatility indices and the resistance indices with the use of sildenafil citrate in our study.
There was a significant increase in the number of cases who developed headache in the intervention group (33.3%) than in the placebo group (10%). We identified no significant differences between the intervention and placebo groups in the neonatal outcome (Birth weight, and NICU admission), this could be due to the fact that the median gestational age at termination in our study was 37 weeks and no neonatal deaths occurred in the intervention group.