Turner J, Dunn L, Tarnow-Mordi W, et al. - Researchers examined whether sildenafil citrate, a vasodilator used in erectile dysfunction and pulmonary hypertension, decreases emergency operative births for fetal compromise and improves fetal or utero-placental perfusion in labor in phase 2 double-blind randomized controlled trial. They randomized women at term in early labor or undergoing scheduled induction of labor at Mater Mother’s Hospital, Brisbane, Australia to receive 50mg sildenafil citrate orally 8 hourly up to 150mg, or placebo. Three hundred women were randomized equally to sildenafil citrate or placebo from September 2015 to January 2019. Sildenafil citrate led to a reduction in the risk of emergency operative birth by 51% and a reduction in the risk of meconium stained liquor or pathological fetal heart rate patterns by 43%. However, its impacts on fetal scalp sampling rates and adverse neonatal outcomes remained inconclusive. Outcomes thereby suggest that operative birth for intrapartum fetal compromise could be reduced with sildenafil citrate.