case_images: PMC4984996_01
case_images: 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.
case_images: ijwh-8-367Fig1.jpg
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case_images: 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.
case_images: 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.
case_images: ijwh-8-367Fig2.jpg
case_images: PMC4984996_01_ijwh-8-367Fig2.jpg
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case_images: 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.
case_images: Doppler of the myometrial placental junction showing a reduced flow at the time of diagnosis of intrauterine growth restriction.
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case_images: PMC4984996_01_ijwh-8-367Fig3.jpg
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case_images: Figure 3 shows the ultrasonography Doppler image with reduced blood flow at the myometrial placental junction at diagnosis of intrauterine growth restriction.
case_images: Doppler of the myometrial placental junction showing an improvement in flow after starting sildenafil citrate.
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case_images: PMC4984996_01_ijwh-8-367Fig4.jpg
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case_images: 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.
case_images: Doppler of umbilical artery showing normalization of systolic/diastolic ratio (2.52) after starting sildenafil citrate.
case_images: ijwh-8-367Fig5.jpg
case_images: PMC4984996_01_ijwh-8-367Fig5.jpg
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case_images: 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.
case_images: 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.
case_images: ijwh-8-367Fig6.jpg
case_images: PMC4984996_01_ijwh-8-367Fig6.jpg
case_images: f6-ijwh-8-367
case_images: 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.