The Dutch STRIDER (Sildenafil TheRapy In Dismal prognosis Early-onset fetal growth Restriction)

Severe, early-onset fetal growth restriction (FGR) due to placental insufficiency is
associated with a high risk of perinatal morbidity with long-lasting sequelae and mortality. Placental insufficiency is the result of abnormal formation and function of the placenta (placentation) with inadequate remodelling of the maternal spiral (uteroplacental) arteries. There is currently no therapy available with demonstrated effectiveness. Evidence suggests Sildenafil citrate improves uteroplacental blood flow, growth, and meaningful outcomes. An objective of the study is to evaluate the effectiveness of sildenafil (versus placebo) in achieving healthy perinatal survival.