Can Metformin be used to prolong pregnancy in preterm pre-eclampsia?

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According to the World Health Organization, the main cause of maternal and fetal morbidity and mortality is pre-eclampsia/eclampsia. In Brazil, eclampsia has a prevalence of 5.2 cases in 1000 live births, ranging from 2.2:1000 in more developed areas to 8.3:1000 in less developed areas.

Therefore, ways to avoid gestante em hospital após uso de metformina para prolongar gestação pre-eclampsia/eclampsia and preterm birth has been studied by several researchers around the world.

gestante em hospital após uso de metformina para prolongar gestação

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Metformin to prolong preterm pregnancy

Recently, a double-blind randomized clinical trial was published in British Medical Journal (BMJ), with the aim of evaluating the use of extended-release metformin in patients at risk of preterm delivery due to pre-eclampsia.

Participated in the study 180 women with pre-eclampsia between 26 + 0 to 31 + 6 weeks of gestation, 90 pregnant women were randomized to the use of extended-release metformin at a dose of 03 g/day and 90 pregnant women entered the placebo group.

Read also: gestante em hospital após uso de metformina para prolongar gestaçãoPregnant woman with pre-diagnosis eclampsia: when to deliver?

Conclusions

According to the authors, the patients who received the drug extended their pregnancy by one week when compared to the placebo group. Animal studies have shown that metformin has the potential to improve trophoblastic invasion, decreasing the oxidative stress of the placental tissue, and it can be a drug used in patients at risk of early pre-eclampsia.

However, more studies are needed for this recommendation to be part of institutional protocols. Cluver ends his article by highlighting that possibly the use of metformin in these patients would reduce the hospitalization of newborns in neonatal intensive care units.

More from the author: The use of acetylsalicylic acid in the prevention of pre-eclampsia

Author:

Graduation in Medicine from the University José do Rosário Vellano ⦁ Residency in Gynecology and Obstetrics at the Regional Hospital of Presidente Prudente ⦁ Specialization in Endometriosis and Minimally Invasive Gynecology at the Hospital Sírio-Libanês ⦁ Specialization in Ultrasonography in Gynecology and Obstetrics at the Faculty of Health Technology ⦁ Ongoing Specialization in Fetal Medicine by Fetus

References:

Cluver CA, Hiscock R, Decloedt EH, Hall DR, Schell S, Mol BW et al. Use of metformin to prolong gestation in preterm pre-eclampsia: randomized, double blind, placebo controlled trial BMJ 2021; 374 :n2103 doi: 10.1136/bmj .n2103 Peraçoli JC, Borges VT, Ramos JG, Cavalli RC, Costa SH, Oliveira LG, et al. Pre-eclampsia/eclampsia. São Paulo: Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo); 2018. (Febrasgo Protocol – Obstetrics, No. 8/National Commission Specialized in Hypertension in Pregnancy).

  • Information sheet: maternal mortality. World Health Organization – WHO, 2020. https://www.paho.org/pt/node/63100
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