The RIDSTRESS study: Reducing the risk of fetal distress with Sildenafil in labour

Project type/s Case control study
Project status Currently underway

Labour is perhaps one of the most dangerous times for a fetus; with up to a 60% reduction in uterine blood flow. This reduction in blood flow may in turn lead to fetal compromise and possibly even brain injury secondary to lack of oxygen. Indeed, events in labour account for up to 1 in 5 cases of cerebral palsy. In the UK, a recent study showed that in 2015, >1000 babies at term suffered significant brain injury or died because of problems during birth.
Sildenafil citrate is a drug that preferentially dilates pelvic blood vessels. Sildenafil Citrate is increasingly being used in pregnancy and in neonates; there is a growing body of evidence regarding its safety both for the mother and the baby. We hypothesize that it will reduce the risk of fetal distress by increasing blood flow to the womb and placenta and thus increasing oxygen availability to the baby. This study will assess if Sildenafil Citrate given in labour can reduce the risk of fetal distress and the need for emergency caesarean section. It is a randomised, placebo-controlled, double blind study taking place over the next three years. We hope to demonstrate that this approach reduces the number of emergency interventions for fetal distress and improves neonatal outcomes.

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