EXPERIENCE IN THE USE OF PDE-5 INHIBITORS (SILDENAFIL) IN THE MANAGEMENT OF PREECLAMSIA: CASE REPORT

Аннотация

In a healthy pregnancy, placental development causes fetal cytotrophoblast cells to infiltrate maternal uterine spiral arterioles, changing the vascular endothelium from an epithelial to an endothelial phenotype, leading to greater blood supply with less resistance. In preeclampsia, trophoblastic invasion is impaired, leading to vascular remodeling that fails to provide adequate blood circulation through spiral arterioles, causing hypoxia and placental ischemia. This environment leads to increased oxidative stress and release of inflammatory cytokines, leading to overall systemic maternal endothelial dysfunction. For the reasons mentioned above, the use of PDE inhibitors is recommended as a treatment for preeclampsia. Inhibition of PDE-5 by sildenafil promotes systemic maternal vasodilation and blood pressure reduction. In addition, it prevents hydrolysis of sGMP, increases its intracellular concentration and reduces uteroplacental hypoperfusion, reduces fetal hypoxia, prolongs pregnancy and improves postpartum outcomes.