Oral N-acetylcysteine administration does not stabilise the process of established severe preeclampsia.
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.
Roes
Eva Maria
EM
Department of Obstetrics & Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Raijmakers
Maarten T
MT
Boo
Theo M de
TM
Zusterzeel
Petra L
PL
Merkus
Hans M
HM
Peters
Wilbert H
WH
Steegers
Eric A
EA
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
D000975:Antioxidants; D016166:Free Radical Scavengers; D006710:Homocysteine; D005978:Glutathione; D000111:Acetylcysteine