الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
Idiopathic recurrent miscarriage constitute a very special group with a debatable way of management. Different drugs have been suggested for management cases of un-explained recurrent miscarriage e.g.Asprin(Rai et al. 2000), prednisolone(Quenby et al., 2003),Progesterone (Oates-Whitehead et al., 2003),Metformin (Glueck et al., 2002),Heparin (DiNisio et al., 2005) and sildenafil (Geoffery et al .,2000). Many studies showed improved uterine artery blood flow and endometrial thickness after the use of low dose vaginal sildenafil .(Sher and fisher.,2000 and jerzak et al .,2002) Most of the studies , used sildenafil for cases of implantation failure (Geoffery et al .,2000), however, only 2 studies , to our knowledge, considered vaginal sildenafil for idiopathic recurrent miscarriage.(Jerzak et al .,2008 and El far et al ., 2009) In our study , we aimed at evaluating the use of low dose vaginal sildenafil for 50 patients with a history of unexplained recurrent miscarriage, recruited from the out patient clinic of Benha university hospital during the period from June 2009 till February 2010. We divided our patients into 2 groups, group I received Asprin and we used it as a control group while we gave group II, in addition to asprin, low dose vaginal sildenafil.25mg/6h from day5 till day 10 of the cycle.
For all our patients we evaluated the endometrial thickness on day 10 of the cycle and we performed Doppler in the same day to evaluate pulsitility index , resistant index and systolic diastolic ration.
Our results showed improvement of endometrial thickness in group II it was increased to 9.78±2.75 while in group I was increased to 8.25±2.15 mm, and uterine artery blood flow in the form of decreased PI in group II, it was 0.78±0.18,while in group I it was 1.98±0.23, decreased RI in group II, it was 0.51±0.04,while in group I it was 0.75±0.12,and decreased S/D ratio in group II it was 1.89±0.60,while in group I was 4.42±1.37. The abortion rate was less in the group who used sildenafil , also the duration of the current abortion was longer in patients who used sildenafil.
In our study , the low dose vaginal sildenafyl had minimal side effects .
Based on the results of our study we may recommend the use of low dose vaginal sildenafil for cases with a history of idiopathic recurrent miscarriage.