Pre-Eclampsia Clinical Trial
Official title:
Pravastatin to Prevent Preeclampsia and Reduce Maternal-Neonatal Mortality and Morbidity in High Risk Preeclampsia Patients
BACKGROUND Preeclampsia is a major cause of maternal and neonatal morbidity worldwide. There
is currently no cure for preeclampsia, the only definitive treatment is termination of
pregnancy by induction of labour or caesarean section. Statin has been proposed to represent
a new approach to improve disease outcome/prevent preeclampsia based on its multilayered
activity toward pregnancy protection, including: protection of vascular endothelial cells
survival, induce expression of heme oxygenase 1 (HO-1), inhibiting the release of soluble
FMS-like tirosine kinase-1 (sFlt-1) and soluble endoglin (sEng), two main culprits in the
pathophysiology of preeclampsia.
OBJECTIVE The aim of this study is to observe the effect of pravastatin administration in
patients with high risk of preeclampsia in order to reduce maternal and neonatal mortality
and morbidity.
METHODS This is a prospective randomized controlled clinical trial. The research will be held
in 5 maternal fetal medicine centers in Indonesia (multicenter study). The recruitment will
be done by permuted block random sampling methods, with sample size around 280 patients
divides into two group. Patients with high risk of preeclampsia will be randomized either to
get pravastatin 2 x 20 mg per oral and aspirin 1 x 80 mg (treatment group) or low dose
aspirin only (control group). The patient will be followed regularly until delivery to obtain
detailed maternal and neonatal outcome.
OUTCOME Primary Outcomes: Maternal preeclampsia, severe preeclampsia, gestational
hypertension, indicated preterm delivery less than 37 weeks, indicated preterm delivery less
than 34 weeks, maternal complications, length of hospital stay, and any serious adverse
event.
Secondary Outcomes: Composite fetal/neonatal mortality and morbidity (stillbirth, neonatal
death, respiratory distress syndrome, intracerebral hemorrhage, neonatal sepsis, intra
uterine growth restriction [Small for Gestational Age (SGA) < 5th centile], and necrotizing
enterocolitis), birthweight, birthweight percentile, level of care (well baby, intermediate,
NICU), NICU length of stay, ventilator usage, and length of perinatal hospital stay.
KEYWORDS: pravastatin, preeclampsia, neonatal mortality, neonatal morbidity
n/a
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