A recent randomized controlled trial by Cluver et al included 180 women with preterm pre-eclampsia between 26+0 to 31+6 weeks' gestation undergoing expectant management: 90 were randomised to extended release metformin and 90 to placebo. Investigators found that extended release metformin (3g daily) can prolong gestation in women with preterm pre-eclampsia. Combination metformin and esomeprazole has shown promise in the treatment of preeclampsia as both agents reduce placental and endothelial secretion of soluble fms-like tyrosine kinase 1 (sFlt-1) and soluble endoglin, and reduce endothelial dysfunction.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
38
Combination 2 g of oral extended release metformin, Esomeprazole 20mg daily until delivery.
Christiana Care Health Systems
Newark, Delaware, United States
mean plasma difference in sFlt-1 from randomization to day 7
Time frame: from randomization to day 7
Mean plasma difference in vascular endothelial growth factor (VEGF)
Time frame: from randomization to day 7
Mean plasma difference in placental growth factor (PlGF) levels
Time frame: from randomization to day 7
Mean plasma difference in soluble endoglin (sEng)
Time frame: from randomization to day 7
Maternal death
Time frame: At time of delivery
Mean highest blood pressure during expectant management mmHg
Time frame: At time of delivery
Number of anti-hypertensive medications at delivery
Time frame: at time of delivery
Fetal growth restriction defined as a sonographic estimated fetal weight (EFW) or abdominal circumference (AC) below the 10th percentile for gestational age using Hadlock cutoffs
Time frame: at time of delivery
Gestational age at delivery
Time frame: at time of delivery
Neonatal intensive care unit (nicu) admission
Time frame: at time of delivery
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.