title: Alpha Lipoic Acid (ALA) effects on subchorionic hematoma: preliminary clinical results.
abstract: OBJECTIVE
  The clinic use of alpha Lipoic Acid (ALA) is linked to its capability to exert antioxidant effects and, more interestingly, to counteract the pathologic changes of complex networks of cytokines, chemokines and growth factors, restoring their physiological state. The aim of this randomized controlled clinical trial was to test the contribution of oral supplementation of ALA to the standard treatment with Progesterone vaginal suppositories, in healing subchorionic hematomas in patients with threatened miscarriage. Controls were administered only Progesterone suppositories.
  
  
  METHODS
  Nineteen pregnant women in the first trimester of gestation, with threatened miscarriage and ultrasound evidence of subchorionic hematoma, were included in the trial and randomly divided in two groups: controls, treated with 400 mg Progesterone (200 mg 2 times per day), given by vaginal suppositories, and case study treated with the same Progesterone dosage, plus ALA, given orally at the dose of 600 mg (300 mg 2 times per day, DAV®, Lo.Li. Pharma srl, Italy). Sixteen patients completed the trial. Treatment was performed until complete resolution of the clinical picture.
  
  
  RESULTS
  In both groups, the subjects improved significantly but, in general, a better and faster evolution in the major signs of threatened miscarriage was observed in the subjects treated with ALA and Progesterone. In these patients, the speed of resorption of subchorionic hematoma was significantly (p ≤ 0.05) superior compared to controls. The ALA and Progesterone group showed a faster decrease or disappearance of all symptoms than that observed in the control group, however the difference was not significant.
  
  
  CONCLUSIONS
  These preliminary results suggest that ALA supplementation significantly contributes to speed up the process of restoration of physiological conditions in threatened miscarriage and ameliorates the medical conditions of both the mothers and the foetus, probably modulating the networks of cytokines, growth factors and other molecules.
authors.affiliation: Department of Obstetrics and Gynecology, University of Perugia, Perugia, Italy. giusy.porcaro@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Porcaro
authors.forename: E
authors.initials: E
authors.lastname: Brillo
authors.forename: I
authors.initials: I
authors.lastname: Giardina
authors.forename: R
authors.initials: R
authors.lastname: Di Iorio
mesh_terms: D000033:Abortion, Threatened / Q000209:etiology / Q000517:prevention & control*; D000328:Adult; D002823:Chorion / Q000473:pathology*; D005260:Female; D006406:Hematoma / Q000188:drug therapy*; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011374:Progesterone / Q000008:administration & dosage; D008063:Thioctic Acid / Q000008:administration & dosage*; D014592:Uterine Hemorrhage / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D011374:Progesterone; D008063:Thioctic Acid