Porcaro, G., Brillo, E., Giardina, I., & Di Iorio, R. (2015). Alpha Lipoic Acid (ALA) effects on subchorionic hematoma: preliminary clinical results. European review for medical and pharmacological sciences.
Porcaro G, Brillo E, Giardina I, Di Iorio R. Alpha Lipoic Acid (ALA) effects on subchorionic hematoma: preliminary clinical results. European review for medical and pharmacological sciences. 2015.
Porcaro, G., et al. "Alpha Lipoic Acid (ALA) effects on subchorionic hematoma: preliminary clinical results." European review for medical and pharmacological sciences, 2015.
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RRM Academy Synopsis
Alpha lipoic acid plus progesterone sped hematoma healing, small trial
In a small trial, adding alpha lipoic acid (ALA) to vaginal progesterone sped hematoma healing. The trial randomized 19 women in early pregnancy with bleeding or pain and a hematoma, and 16 finished. Bleeding, pain and contractions also tended to ease faster with ALA.
Study at a glance, randomized controlled trial of Nineteen women: ALA with progesterone sped hematoma healing in a small trial. Source: Porcaro G et al., 2015, PMID 26439038.
Key Findings
Nineteen women were enrolled and 16 finished: 9 took ALA plus vaginal progesterone and 7 took vaginal progesterone alone.
Hematoma resorption differed between the groups (Mann-Whitney U = 8; critical U at p ≤ 0.05 = 12), favoring ALA plus progesterone.
At the second check, 3 weeks after baseline, 0 of 9 women in the ALA group had contractions, against 5 of 7 (71%) on progesterone alone.
Differences in bleeding, pelvic pain and contractions were not statistically significant. The paper reports no adverse effect on mother or fetus.
Interpretation
This randomized controlled trial followed women with early pregnancy bleeding and a hematoma. The trial ran at one Italian university clinic from March 2013 to February 2014. Ultrasound measured hematoma size against the gestational sac. Neither group had a case of threatened miscarriage, preterm birth or placental abruption. The authors call the results preliminary. The findings support larger trials of ALA with progesterone for this condition.
RRM Context
The authors note that doctors prescribe progesterone for threatened miscarriage, though few studies back it. RRM considers early pregnancy bleeding as a question of cause.
Our editorial summary of this paper, not the article's abstract.
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.
Patients and 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.
