الفهرس 
Unexpllaiined rrecurrrrentt miiscarrrriiageOnly 14 pages are availabe for public view
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Abstract
SUMMARY & CONCLUSION
he aim of the study is to measure the effect of oral
sildenafil citrate 25 mg on serum levels of total
antioxidant capacity in patients with unexplained recurrent
miscarriages.
This prospective case control study was conducted at Ain
Shams University Maternity Hospital outpatient clinics. The
study included 180 women who were divided into 2 groups:
(group 1) which included 91 patients who took sildenafil citrate
25 mg orally, 4 times per day for 21 days (Sildenafil 25 mg
tablet, EIPICO, Inc, Cairo, Egypt) and (group 2) which
included 89 patients who took placebo orally, 4 times per day
for 21 days.
Our inclusion criteria was: age 18-35 years and ≥ 3
recurrent spontaneous abortions before the 24th week of
gestation with no apparent cause for their previous losses and
Three or more months have elapsed since the last abortion in
Postmenstrual period and no other therapy allowed during our
treatment course.
Our exclusion criteria was: Concomitant use of organic
nitrites, or nitrates, any severe hepatic, renal, or cardiovascular
impairment, history of stroke or myocardial infarction or
patients with retinitis pigmentosa.
Every subject was subjected to verbal consent, detailed
history to ensure our inclusion and exclusion criteria and all
women had systematic investigations including
hysterosalpingogram, coagulation.
Profile, thyroid function test, pelvic ultrasound scan,
anticardiolipin antibodies IgG and IgM, lupus anticoagulant
antibodies, and hormonal analysis (including progesterone,
prolactin, androgens, and early follicular FSH, and LH). And
possible side effects including: Common effects: headache,
flushing, dyspepsia, nasal congestion, blurring of vision,
photophobia, cyanopsia (blue vision), dizziness, postural
hypotension, and urinary tract infection.
Other minor effects: palpitations, diarrhea, vomiting,
sweating, backache, and arthralgia. Rare serious effects: loss of
peripheral vision, allergic reaction, sudden hearing loss, and
chest pain. And withdrawal of 5 ml of a venous blood sample
twice was done before the intervention and after 21 days to
measure total antioxidant capacity by antioxidant assay trolox
technique.
Regarding our results there was no significant statistical
difference between the two studied groups as regard age,
duration of marriage, maternal smoking, previous labor, past
history DM.
Also, there was no statistical significant difference
between the two studied groups as regard FSH, T3, T4, TSH,
prolactin, anticardiolipin IgG, anticardiolipin IgM, PTT and
INR but significance only in LH.
The statistical comparison between group I (sildenafil
citrate) and group II (placebo) before administration of drug
regarding expected sildenafil citrate side effects shows
significance in flushing only but the statistical comparison
between group I (sildenafil citrate) and group II (placebo) after
administration of drug regarding expected sildenafil citrate side
effects shows significance in headache only.
Also the statistical comparison in patients in group I
(sildenafil citrate) before and after administration of drug
regarding expected sildenafil citrate side effects shows
significance in headache and palpitations and the statistical
comparison in patients in group II (placebo) before and after
administration of drug regarding expected sildenafil citrate side
effects shows significance in dizziness, postural hypotension.
The statistical comparison in patients in group I
(sildenafil citrate) and group II (placebo) before administration
of drug regarding total antioxidant capacity shows non
significance in total antioxidant capacity but the statistical
comparison in patients in group I (sildenafil citrate) and group
II (placebo)after administration of drug regarding shows
significance in total antioxidant capacity.Also the statistical
comparison in patients in group I(sildenafil citrate) before and
after administration of the drug regarding total antioxidant
capacity shows significance in total antioxidant capacity.
statistical comparison in patients in group II (placebo)
before and after administration of drug regarding total
antioxidant capacity shows non significance in total antioxidant
capacity.
In conclusion, sildenafil citrate has an effective role in
increasing the level of total antioxidant capacity in patients with
history of recurrent miscarriage which may have a role in
helping these patients.