title: Oral N-acetylcysteine administration does not stabilise the process of established severe preeclampsia.
abstract: OBJECTIVE
  To stabilise the disease process in women with early onset severe preeclampsia and/or HELLP syndrome by enhancing maternal antioxidants effects of glutathione.
  
  
  METHODS
  In a randomised, double-blind, placebo-controlled trial, women with severe preeclampsia and/or HELLP syndrome received oral N-acetylcysteine. Primary outcome measures were disease stabilisation expressed as treatment-to-delivery interval and biochemical assessment of glutathione and parameters of oxidative stress. Secondary outcome measures were maternal complications, rate of caesarean section, stay at intensive care unit, postpartum hospital stay and neonatal morbidity and mortality. Analyses were done by intention-to-treat using Wilcoxon's two-sample test and regression analysis.
  
  
  RESULTS
  Median treatment-to-delivery interval was not significantly different between the N-acetylcysteine and placebo group. The whole blood and plasma levels of glutathione and other thiols were not affected by N-acetylcysteine administration, except for plasma homocysteine concentrations, which were lower in the N-acetylcysteine group. There were no differences found in maternal nor neonatal secondary outcome measures between both groups.
  
  
  CONCLUSIONS
  Oral N-acetylcysteine administration does not stabilise the disease process of early onset severe preeclampsia and/or HELLP syndrome.
authors.affiliation: Department of Obstetrics & Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Eva Maria
authors.initials: EM
authors.lastname: Roes
authors.forename: Maarten T
authors.initials: MT
authors.lastname: Raijmakers
authors.forename: Theo M de
authors.initials: TM
authors.lastname: Boo
authors.forename: Petra L
authors.initials: PL
authors.lastname: Zusterzeel
authors.forename: Hans M
authors.initials: HM
authors.lastname: Merkus
authors.forename: Wilbert H
authors.initials: WH
authors.lastname: Peters
authors.forename: Eric A
authors.initials: EA
authors.lastname: Steegers
mesh_terms: D000111:Acetylcysteine / Q000008:administration & dosage* / Q000494:pharmacology*; D000284:Administration, Oral; D000328:Adult; D000975:Antioxidants / Q000008:administration & dosage* / Q000494:pharmacology*; D004311:Double-Blind Method; D005260:Female; D016166:Free Radical Scavengers / Q000008:administration & dosage / Q000494:pharmacology; D005978:Glutathione / Q000097:blood / Q000187:drug effects; D017359:HELLP Syndrome / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism; D006710:Homocysteine / Q000097:blood; D006801:Humans; D018384:Oxidative Stress / Q000187:drug effects; D011225:Pre-Eclampsia / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism; D011247:Pregnancy; D012044:Regression Analysis; D016896:Treatment Outcome
chemical_list: D000975:Antioxidants; D016166:Free Radical Scavengers; D006710:Homocysteine; D005978:Glutathione; D000111:Acetylcysteine