PMC4984996_01
Doppler of umbilical artery showing an increase in systolic/diastolic ratio (3.54) at the time of diagnosis of intrauterine growth restriction and starting sildenafil citrate.. Abbreviations: PSV, peak systolic velocity; EDV, end diastolic velocity; MDV, mean diastolic velocity; TAPV, timed averaged peak velocity; S/D, systolic/diastolic ratio; PI, pulsatility index; RI, resistive index; HR, heart rate.
ijwh-8-367Fig1.jpg
PMC4984996_01_ijwh-8-367Fig1.jpg
f1-ijwh-8-367
Color Doppler showed an increased S/D ratio in the umbilical arteries with brain-sparing effect in the middle cerebral artery (MCA) as shown in Figures 1 and 2.
Doppler of the middle cerebral artery showing an increase in systolic/diastolic ratio (4.29) and brain-sparing effect at the time of diagnosis of intrauterine growth restriction and initiating sildenafil citrate.. Abbreviations: PSV, peak systolic velocity; EDV, end diastolic velocity; MDV, mean diastolic velocity; TAPV, timed averaged peak velocity; S/D, systolic/diastolic ratio; PI, pulsatility index; RI, resistive index; HR, heart rate.
ijwh-8-367Fig2.jpg
PMC4984996_01_ijwh-8-367Fig2.jpg
f2-ijwh-8-367
Color Doppler showed an increased S/D ratio in the umbilical arteries with brain-sparing effect in the middle cerebral artery (MCA) as shown in Figures 1 and 2.
Doppler of the myometrial placental junction showing a reduced flow at the time of diagnosis of intrauterine growth restriction.
ijwh-8-367Fig3.jpg
PMC4984996_01_ijwh-8-367Fig3.jpg
f3-ijwh-8-367
Figure 3 shows the ultrasonography Doppler image with reduced blood flow at the myometrial placental junction at diagnosis of intrauterine growth restriction.
Doppler of the myometrial placental junction showing an improvement in flow after starting sildenafil citrate.
ijwh-8-367Fig4.jpg
PMC4984996_01_ijwh-8-367Fig4.jpg
f4-ijwh-8-367
Repeat ultrasound at 28 weeks showed an improvement in blood flow and an increase in AFI to 6.5 with a fetal weight of 680 g after starting sildenafil citrate as shown in Figure 4.
Doppler of umbilical artery showing normalization of systolic/diastolic ratio (2.52) after starting sildenafil citrate.
ijwh-8-367Fig5.jpg
PMC4984996_01_ijwh-8-367Fig5.jpg
f5-ijwh-8-367
Gradually at 31 weeks, there was further decrease in pulsatility index, and S/D ratio was <3, in both umbilical and MCAs as shown in Figures 5 and 6.
Doppler of umbilical artery showing normalization of systolic/diastolic ratio (2.74) after starting sildenafil citrate.. Abbreviations: PSV, peak systolic velocity; EDV, end diastolic velocity; MDV, mean diastolic velocity; TAPV, timed averaged peak velocity; S/D, systolic/diastolic ratio; PI, pulsatility index; RI, resistive index; HR, heart rate.
ijwh-8-367Fig6.jpg
PMC4984996_01_ijwh-8-367Fig6.jpg
f6-ijwh-8-367
Gradually at 31 weeks, there was further decrease in pulsatility index, and S/D ratio was <3, in both umbilical and MCAs as shown in Figures 5 and 6.