Oral plus vaginal alpha-lipoic acid in women at risk for preterm delivery

IJMDAT 2018; 1 (1): e104

  Topic: Gynecology     Category:

Abstract

Objective: The etiology of preterm labor is multifactorial. An inflammatory response is always involved with the activation of NF-kB that determines synthesis and release of inflammatory molecules, implicated in fetal membrane activation, cervical modifications, abdominal pain and spontaneous uterine contractions. There is a close relationship between preterm birth and cervical shortening in the second quarter of pregnancy. We evaluated the benefits of alpha-lipoic acid administration on women considered at risk of preterm delivery due to the presence of symptoms (pelvic pain and uterine contractions) or reduced cervical length.
Patients and Methods: This prospective observational study was carried out at the Gynecology and Obstetrics Unit of Palermo University Hospital (Palermo, Italy), from October 2015 to April 2016. The inclusion criteria were: women aged 18-35, with gestational age between 24 and 33 weeks of amenorrhea, pregnancy at risk of preterm delivery due to cervical length between 35-25 mm (in presence of symptoms) or < 30 and > 15 mm (if asymptomatic), intact membranes and negative for vaginosis. Patients were treated daily with alpha lipoic acid orally (300 mg, twice a day for 30 days) and vaginally (10 mg, once a day for 10 days), or untreated (controls). Patients were evaluated at the baseline (T 0), after 7 days, after 30 days, and at 34 weeks of gestation considering: maternal characteristics, symptomology and cervical length.
Results: Among 60 analyzed women, 50 were treated orally and vaginally with alpha-lipoic acid, whereas 10 did not undergo any therapy. In the treated group, 10 patients were asymptomatic and 40 symptomatic. The symptoms disappeared in 37 patients. In the untreated group, 4 women were symptomatic and 6 asymptomatic. At the end all women were symptomatic. Mean cervical length showed a reduction in the untreated group compared to the treated group.
Conclusions: The vaginal/oral-combined administration with alpha-lipoic acid showed effectiveness in reducing symptoms and preventing cervical shortening in our set of patients. No adverse effects were detected during the treatment.

To cite this article

Oral plus vaginal alpha-lipoic acid in women at risk for preterm delivery

IJMDAT 2018; 1 (1): e104

Publication History

Submission date: 27 Nov 2017

Revised on: 11 Dec 2017

Accepted on: 14 Dec 2017

Published online: 27 Mar 2018