{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T17:06:18Z","timestamp":1754154378414,"version":"3.41.2"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T00:00:00Z","timestamp":1694995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare cost\u2010effectiveness of oral sildenafil citrate, administered after onset of labor, with standard care to health system funders in the UK and Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a modeled cost\u2010effectiveness analysis, measuring costs and quality adjusted life years (QALYs), using a decision\u2010analytic model covering onset of labor to 1\u2009month post\u2010birth. The relative risk of emergency cesarean section and operative vaginal birth was taken from a Phase 2 placebo controlled double blinded randomized control trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both options of care resulted in the same QALYs gained over the model time period (0.08). Sildenafil citrate was cost\u2010saving compared with standard care, saving \u00a392 per birth in the UK (AU$303 per birth in Australia). Sensitivity analyses did not identify any areas of uncertainty that stopped sildenafil citrate being cost saving compared with standard care. Threshold analysis revealed that sildenafil citrate would be cost saving up to a per birth drug or administration cost of \u00a3152.32 in the UK (AU$333.61 in Australia).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Oral sildenafil citrate may be cost saving compared with standard care; however, the effects on neonatal outcomes still need to be demonstrated in large randomized trials.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.15135","type":"journal-article","created":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T02:48:28Z","timestamp":1695091708000},"page":"1010-1018","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Intrapartum use of sildenafil citrate to prevent fetal compromise and emergency operative birth in term pregnancies in the United Kingdom and Australia: A\u00a0preliminary cost\u2010effectiveness analysis"],"prefix":"10.1002","volume":"164","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7233-6804","authenticated-orcid":false,"given":"Emily J.","family":"Callander","sequence":"first","affiliation":[{"name":"School of Public Health University of Technology Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Tarnow\u2010Mordi","sequence":"additional","affiliation":[{"name":"NHMRC Clinical Trials Centre University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachael","family":"Morton","sequence":"additional","affiliation":[{"name":"NHMRC Clinical Trials Centre University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben W.","family":"Mol","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sailesh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Mater Research Institute and Mayne Academy University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,9,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2021-005671"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31928-7"},{"volume-title":"NHS Maternity Statistics, England 2019\u201320","year":"2021","author":"National Health Service","key":"e_1_2_9_4_1"},{"key":"e_1_2_9_5_1","first-page":"80","volume-title":"Australia's Health 2018, in Australia's health series no. 16","author":"Australian Institute of Health and Welfare","year":"2018"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31930-5"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31927-5"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12530"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2021.100479"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.111720"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.07.032"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-cellbio-100814-125620"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1185\/030079903125001839"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1159\/000453062"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.01.025"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462313000160"},{"volume-title":"Methods for the Economic Evaluation of Health Care Programmes","year":"2015","author":"Drummond MF","key":"e_1_2_9_17_1"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-017816"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2009.01.040"},{"volume-title":"Can Intrapartum Sildenafil Citrate Safely Avert the Risks of Contraction\u2010Induced Hypoxia in Labour? iSEARCH \u2013 a Pragmatic Multicentre Phase III Randomised Controlled Trial. 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