Evidence map›Paper›PMID 41989957›Full record

ArticleNeonatology2026

Fetal Tadalafil Exposure Increases Pulmonary Blood Flow and Reduces Right to Left Heart Shunting through the Foramen Ovale.

Janna L Morrison, Georgia K Williams, Steven K S Cho, Ashley S Meakin, Stacey L Holman, Megan Quinn, Michael D Wiese, Christopher K Macgowan, Mike Seed, Jack R T Darby

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Article in Neonatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Janna L MorrisonEarly Origins of Adult Health Research Group, Robinson Research Institute, Adelaide, South Australia, Australia, janna.morrison@adelaide.edu.au.
Georgia K WilliamsSouth Australian Health and Medical Research Institute, Preclinical, Imaging and Research Laboratories, Adelaide, South Australia, Australia.
Steven K S ChoEarly Origins of Adult Health Research Group, Robinson Research Institute, Adelaide, South Australia, Australia.
Ashley S MeakinEarly Origins of Adult Health Research Group, Robinson Research Institute, Adelaide, South Australia, Australia.
Stacey L HolmanEarly Origins of Adult Health Research Group, Robinson Research Institute, Adelaide, South Australia, Australia.
Megan QuinnEarly Origins of Adult Health Research Group, Robinson Research Institute, Adelaide, South Australia, Australia.
Michael D WieseSchool of Pharmacy and Biomedical Sciences, College of Health, Adelaide University, Adelaide, South Australia, Australia.
Christopher K MacgowanUniveristy of Toronto and The Hospital for Sick Children, Toronto, Ontario, Canada.
Mike SeedUniveristy of Toronto and The Hospital for Sick Children, Toronto, Ontario, Canada.
Jack R T DarbyEarly Origins of Adult Health Research Group, Robinson Research Institute, Adelaide, South Australia, Australia, jack.darby@adelaide.edu.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionFetal growth restriction (FGR) increases the risk of poor in utero, neonatal, and long-term health outcomes. Tadalafil (TAD) is the current focus of a phase II exploratory trial (TADAFER IIb) to determine its efficacy as an intervention for FGR. Herein, we aimed to determine the impact that TAD has on fetal hemodynamics.

methodsAt 116-117 days of gestational age (dGA), pregnant ewes carrying normally grown fetuses (n = 9) underwent fetal catheterization surgery before undergoing MRI scans at 119-123 dGA to measure blood flow and oxygenation within the major vessels of the fetal circulation using phase contrast MRI and T

resultsTAD did not impact right or left ventricular (LV) output but was associated with an increase in pulmonary blood flow with reduced blood flow through both the ductus arteriosus and foramen ovale (FO). The difference in blood oxygenation between the ascending aorta and main pulmonary artery was significantly reduced, but cerebral oxygen delivery was maintained by increased carotid artery blood flow.

conclusionFetal TAD exposure alters pulmonary hemodynamics and reduces the proportion of the LV preload blood pool that is made up of oxygen-rich blood from the FO. Given fetal exposure to sildenafil increases the rate of persistent pulmonary hypertension after birth and that the TAD exposed fetuses studied herein exhibited similar hemodynamic profiles as those exposed to sildenafil, further studies investigating neonatal outcomes of fetuses exposed to TAD are warranted.

Indexed as

Cardiovascular systemFetal growth restrictionHemodynamicsHypoxiaIUGRMRIPhase contrast MRIT2 oximetryTADAFERTadalafil

Identifiers

PMID41989957
PMCPMC13252918

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