Role of Metformin in prevention of hypertensive disorders of pregnancy : A randomized clinical trial / Aya Mohamed Ahmed Abdelhamid ; Supervised Ahmed Mohamed Abdelhakk , Sarah Mohamed Hassan , Mohamed Ahmed Hamza

Thesis (M.Sc.) - Cairo University - Faculty of medicine - Department of Gynecology & Obstetrics

Objectives: Assessment of effectiveness of metformin in prevention of Hypertensive disorders of pregnancy and reduction of maternal and fetal morbidity and mortality. Subjects and Methods: an experimental randomized clinical trial (single blinded study) conducted from August 2019 to May 2020 in the Obstetric outpatient clinic at Cairo University Hospitals. The study included a total of 300 pregnant females attend obstetric outpatient clinic for antenatal care who met the inclusion and exclusion criteria. Eligible women were randomly assigned, in a 1:1 ratio with the use of computer- generated random numbers, to allocate into one of the study two groups: Group (1): received the usual Antenatal care and 500 mg Metformin tab twice daily from enrollment day till time of delivery. Group (2): received the usual Antenatal care and placebo . All patients were subjected to full history taking, general physical examination, local pelvic examination, ultrasound scan, monthly Alb / creatinine ratio and complete blood picture. Every patient came at least for 10 Antenatal care visits. The primary outcome of the study was to assess the rate of development of hypertensive disorders of pregnancy .Main Results: The prevalence of Gestational HTN as well as the prevalence of preeclampsia was significantly lower among pregnant females in the Metformin Group vs. in the placebo group (p-values= 0.036, 0.035 respectively). No statistically significant differences between both groups regarding the occurrence of eclampsia and HELLP Syndrome. Umbilical artery Doppler abnormality as well as Middle Cerebral Artery Doppler abnormality were less prevalent among participants in the Metformin Group vs. in the placebo group, (p-value= 0.036 and 0.036). High Alb. /Creatinine ratio was less prevalent among participants in the Metformin Group vs. in the placebo group, (p-value= 0.035). Intra-uterine growth retardation (IUGR) was significantly more prevalent among placebo group as compared with metformin group (p-value= 0.006).Neonatal birth weight (gm.) was significantly higher among metformin group as compared with placebo group (p-value= 0.006). There were no other important differences identified for majority of maternal and infant secondary outcomes in this clinical trial.)

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