Epigallocatechin gallate enhances treatment efficacy of oral nifedipine against pregnancy-induced severe pre-eclampsia: A double-blind, randomized and placebo-controlled clinical study.

WHAT IS KNOWN AND OBJECTIVE: Oral nifedipine is commonly used to treat pre-eclampsia, one of the most severe complications during pregnancy, but its clinical efficacy is less than ideal. Epigallocatechin gallate (EGCG), a natural compound from green tea, could benefit cardiovascular health especially hypertension. We investigated the clinical efficacy of EGCG, when complemented with oral nifedipine, in treating pre-eclampsia. METHODS: A total of 350 pregnant women with severe pre-eclampsia were recruited and randomized to receive oral nifedipine, together with placebo (NIF+placebo) or EGCG (NIF+EGCG). The primary treatment outcome was the time needed to control blood pressure and interval time before a new hypertensive crisis, whereas the secondary treatment outcome was the number of treatment doses to effectively control blood pressure, maternal adverse effects and neonatal complications. RESULTS AND DISCUSSION: Comparing NIF+EGCG group to NIF+placebo group, the time needed to control blood pressure was significantly shorter (NIF+EGCG 31.2±16.7 minutes, NIF+placebo 45.3±21.9 minutes; 95% CI 9.7-18.5 minutes), whereas interval time before a new hypertensive crisis was significantly prolonged (NIF+EGCG 7.2±2.9 hours, NIF+placebo 4.1±3.7 hours; 95% CI 2.3-3.9 hours), and the number of treatment dosages needed to effectively control blood pressure was also lower. Between the two treatment groups, no differences in incidence rates of maternal adverse effects or neonatal complications were observed. WHAT IS NEW AND CONCLUSIONS: EGCG is both safe and effective in enhancing treatment efficacy of oral nifedipine against pregnancy-induced severe pre-eclampsia, but formal validation is required prior to its recommendation for use outside of clinical trials.

Oral nifedipine vs. intravenous labetalol for treatment of pregnancy-induced severe pre-eclampsia.

WHAT IS KNOWN AND OBJECTIVE: Pre-eclampsia is one of the most challenging diseases of pregnancy. Both nifedipine and labetalol have been used for treatment of pregnancy-induced severe pre-eclampsia. METHODS: In the present study, the efficacy and safety of oral nifedipine and intravenous labetalol for severe pre-eclampsia therapy were compared. Eligible pregnant women with severe pre-eclampsia (n = 147) were allocated to receive either oral nifedipine or intravenous labetalol. The primary endpoint of the study was the time needed to achieve target blood pressure. Secondary outcomes were the time interval before a new hypertensive crisis following effective blood pressure control, number of doses and adverse effects. RESULTS AND DISCUSSION: We found that the time taken to achieve effective blood pressure control was 35 vs. 42 min for oral nifedipine and intravenous labetalol, respectively (P = 0·37). Compared with labetalol group, no significant difference was observed regarding time interval and drug dosages in nifedipine arm. Moreover, no serious side effects on maternal or perinatal were observed in either group. WHAT IS NEW AND CONCLUSIONS: These findings suggest that both oral nifedipine and intravenous labetalol are effective for safely reducing blood pressure to target levels in patients with severe pre-eclampsia.