Turner JM, Russo F, DePrest J, et al. - This systematic review was performed with the aim to determine the safety profile and clinical outcomes of phosphodiesterase-5 inhibitors used for the treatment of severe early onset preeclampsia and fetal growth restriction during pregnancy. Performing a search in Embase, PubMed, CENTRAL, Prospero and Google Scholar, 1,324 citations were identified. Of these, 16 studies including 1,679 participants met the inclusion criteria – 2 studies reported the use of Tadalafil while 14 used Sildenafil. Findings from this meta-analysis indicate association of using phosphodiesterase-5 inhibitors in pregnancy with mild maternal side effects. If these are used for indications other than treatment of fetal growth restriction, a reduction in the relative risk of operative birth for fetal compromise in labor and higher vaginal birth rates were recorded. However, an increase in the risk of persistent pulmonary hypertension of the newborn and neonatal death was observed in correlation with its prolonged use for the treatment of severe early onset fetal growth restriction.