Effect of Sildenafil Citrate on Uteri- Placental Perfusion, Doppler Indices in Growth Restricted Fetuses

Inclusion Criteria: Patients were admitted to the study based on the following inclusion criteria: 1. Any age and any party. 2. Body mass index between 25 and 35. 3. Singleton pregnancy. 4. Gestational age of 24 weeks or more. Gestational age was established on the basis of menstrual dates and confirmed by first or second trimester ultrasound for booked patients, however, if a difference of \> 7 days or \> 10 days during first or second trimester respectively, then ultrasound value was used. For unbooked patients they still have the chance to be included in our study if they can bring a scan that showed gestational age during the same period mentioned before. 5. Idiopathic intrauterine growth restriction. 6. Intrauterine growth restriction due to maternal malnutrition, maternal medical disorder as anemia, pregnancy induced hypertension, or chronic renal disease. 7. Intrauterine growth restriction due to substance abuse (including smoking). 8. With or without past history of intrauterine growth restriction . Exclusion Criteria: 1. Intrauterine growth restriction due to fetal causes as congenital abnormalities, fetal infection, or multiple gestation. 2. Any drug therapy that can affect fetal growth or fetal blood supply. 3. Maternal diseases that contraindicates the use of sildenafil citrate