الفهرس 
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Abstract
This study was done in Menoufia University hospital at the department of Obstetrics and Gynecology from April 2015 to April 2017. The aim of the study was to assess the effect of use of alpha methyldopa, labetalol, nifedipine or sildenafil in mild preeclampsia on pregnancy outcomes (maternal or fetal) and their effect on uterine,umbilical or middle cerebral arteries Doppler. The study included 200 pregnant nullipara with mild preeclampsia:
Complete history,examination,ultrasound including Doppler on uterine, umbilical and middle cerebral arteries , CTG and laboratory investigations were done.
The patients were divided into five equal groups:
group I: included 40 women who received alpha methyldopa750 mg-2000 mg per day as antihypertensive (Aldomet 250 mg tab, Kahira pharm company, cairo).
group II: included 40 women who received labetalol 100 mg twice per day as antihypertensive maximum dose 400 mg per day(Labipress100 mg tab, dBK pharma).
group III: included 40 women who received nifedipine oral sustained tablets 20-120mg per day as antihypertensive (Epilat Retard tab 20 mg, EIPICO).
group IV: included 40 women who received sildenafil 100 mg per day (VIAGRA 100 mg tab, Pfizer)
group V: included 40 women with mild preeclampsia not received antihypertensive drugs or sildenafil.
Follow up of the patients was done with assessment of the outcome measures and statistical analysis was done and revealed that the use of alpha methyldopa, nifedipine, labatalol or sildenafil in mild preeclampsia produce significant reduction of blood pressure ,prolong pregnancy duration, decrease the need for maternal admission to the ICU due to uncontrolled severe hypertension ,decrease insignificantly the progression of mild preeclampsia to severe preeclampsia without producing negative effect on the mother or the fetus because these drugs did not impair the uteroplacental or middle cerebral blood flow documented by Doppler studies.
Labetalol is ideal first line of treatment because it has potent and fast hypotensive effect without producing significant side effects on the mother or fetus. More studies will be needed to assess use of sildenafil without antihypertensive in mild preeclampsia.