The Impact of Silymarin on Improvement of Hepatic Abnormalities in Patients with Severe Preeclampsia
A Randomized Clinical Trial
Keywords:
Preeclampsia, Silymarin, Liver enzymesAbstract
Background: Preeclampsia is a pregnancy-specific disorder, associated with increased blood pressure and proteinuria, and in extreme cases it can also cause liver and kidney problems.
Objective: To determine the impact of silymarin on the improvement of severe preeclampsia.
Methods: This randomized clinical trial was conducted at Hajar Hospital in Shahrekord, Iran, from April 2014 to September 2015. Sixty patients whose pregnancy had ended as a result of severe preeclampsia, were entered into the study. Patients were randomly divided into two groups of thirty study and control groups. In addition to current treatment for preeclampsia, case groups were administered 70 mg of silymarin, three and twenty four hours after the termination of pregnancy. The control group received placebo at the same time. The blood pressure and AST, ALT, ALP, LDH, uric acid, bilirubin and kidney tests were compared at the baseline and 12, 36 and 60 hours post- measurements in two groups by SPSS software, version 22, by the ANOVA test, and by the independent-samples t-test.
Results: AST and ALT liver enzyme levels decreased significantly 36 and 60 hours after the termination of pregnancy in the study group compared to the control group (p <0.01).
Conclusion: Silymarin is used to treat liver disorders, and has beneficial results. It seems that this drug can be used for accelerating improvement of liver disorders in severe preeclampsia. However, adjusting the dose of the drug for the treatment of liver disorders in severe preeclampsia requires further studies.
Clinical trial registration: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT201509042388/N1.
Funding: Shahrekord University of Medical Sciences supported this research (project no. 2006).
References
Cunninghum FG, Leveno KG, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams Obstetrics. 23nd ed.
Newyork: McGraw-Hill. 2014; 21: 761-80.
von Dadelszen P, Firoz T, Donnay F, Gordon R, Hofmeyr GJ, Lalani S, et al. Preeclampsia in low and
middle income countries-health services lessons learned from the PRE-EMPT (PRE-Eclampsia-Eclampsia
Monitoring, Prevention and Treatment) project. J Obstet Gynaecol Can. 2012; 34(10): 917-26. PMID:
Engelhardt T, MacLennan FM. Fluid management in pre-eclampsia. Int J Obstet Anesth. 1999; 8(4): 253-9.
doi: 10.1016/S0959-289X(99)80106-X. PMID: 15321120.
Hutcheon JA, Lisonkova S, Joseph KS. Epidemiology of preeclampsia and the other hypertensive disorders
of pregnancy. Best Pract Res Clin Obstet Gynaecol. 2011; 25(4): 391-403. doi:
1016/j.bpobgyn.2011.01.006. PMID: 21333604.
Masoudi M, Miraj S, Rafieian-Kopaei M. Comparison of the Effects of Myrtus Communis L, Berberis
Vulgaris and Metronidazole Vaginal Gel alone for the Treatment of Bacterial Vaginosis. J Clin Diagn Res.
; 10(3): 4-7. doi: 10.7860/JCDR/2016/17211.7392. PMID: 27134945, PMCID: PMC4843330.
Miraj S, Rafiean Kopaei M, Kiani S. Melissa officinalis L: A Review Study with an Antioxidant
Prospective. Journal of Evidence-Based Complementary & Alternative Medicine. 2016; 21(4). doi:
1177/2156587216663433.
Seyyedi F, Rafiean-Kopaei M, Miraj S. Comparison of the Effects of Vaginal Royal Jelly and Vaginal
Estrogen on Quality of Life, Sexual and Urinary Function in Postmenopausal Women. J Clin Diagn Res.
; 10(5): 1-5. doi: 10.7860/JCDR/2016/17844.7715. PMID: 27437306, PMCID: PMC4948482.
Miraj S, Kaveh Baghbahadorani F. The impact of Silymarin on antioxidant capacity of serum and lipid
peroxidation in patients with severe pre-eclampsia. Der Pharmacia Lettre. 2016; 8(6): 29-32.
Baghbahadorani FK, Miraj S. The impact of Silymarin on improvement of platelet abnormalities in patients
with severe preeclampsia. Electron Physician. 2016; 8(5): 2436-42. doi: 10.19082/2436. PMID: 27382456,
PMCID: PMC4930266.
Feher J, Lengyel G. Silymarin in the prevention and treatment of liver diseases and primary liver cancer.
Curr Pharm Biotech. 2012; 13(1): 210-7. PMID: 21466434.
Pellegrini L, Belcaro G, Dugall M, Hu S, Gizzi G, Corsi M, et al. Supplementary management of
functional, hepatic damage with Liverubin (pharma-standard Silymarin). A 3-month registry. Minerva
Gastroenterol Dietol. 2015. PMID: 26448308.
Aller R, Izaola O, Gómez S, Tafur C, González G, Berroa E. Effect of silymarin plus vitamin E in patients
with non-alcoholic fatty liver disease. A randomized clinical pilot study. Eur Rev Med Pharmacol Sci.
; 19(16): 3118-24. PMID: 26367736.
Giorgi VS, Peracoli MT, Peracoli JC, Witkin SS, Bannwart-Castro CF. Silibin modulates the NF-kb
pathway and proinflammatory cytokine production by mononuclear cells from preeclamptic women. J
Reprod Immunol. 2012; 95(1-2): 67-72. doi: 10.1016/j.jri.2012.06.004. PMID: 22871551.
Martines G, Piva M, Copponi V, Cagnetta G. [Silymarin in pregnancy and during hormonal contraceptive
treatment. Blood chemistry and ultrastructural findings in the experimental model]. Arch Sci Med (Torino).
; 136(3): 443-54. PMID: 549550.
Souza CO, Peraçoli MT, Weel IC, Bannwart CF, Romão M, Nakaira-Takahagi E. Hepatoprotective and
anti-inflammatory effects of silibin on experimental preeclampsia induced by L-NAME in rats. Life sci.
; 91(5-6): 159-65. doi: 10.1016/j.lfs.2012.06.036. PMID: 22781706.
Reid C, Edwards J, Wang M, Manybeads Y, Mike L, Martinez N, et al. Prevention by a silymarin
phospholipid compound of ethanol induced social learning deficits in rats. Planta Med. 1999; 65(5): 421-4.
doi: 10.1055/s-1999-14085. PMID: 10418328.
La Grange L, Wang M, Watkins R, Ortiz D, Sanchez ME, Konst J, et al. Protective effects of the flavonoid
mixture silymarin on fetal brain and liver. J Ethnopharmacol. 1999; 65(1): 53-61. PMID: 10350368.
Kassem LM, Abdelrahim MEA, Naguib HF. Investigating the efficacy and safety of silymarin in
management of hyperbilirubinemia in neonatal jaundice. Med Sci. 2013; 2(2): 575-90. doi:
5455/medscience.2013.02.8057.
Fallahzadeh MK, Dormanesh B, Sagheb MM, Roozbeh J, Vessal G, Pakfetrat M, et al. Effect of addition of
silymarin to renin-angiotensin system inhibitors on proteinuria in type 2 diabetic patients with overt
nephropathy: a randomized, double-blind, placebo-controlled trial. Am J Kidney Dis. 2012; 60(6): 896-903.
doi: 10.1053/j.ajkd.2012.06.005. PMID: 22770926.
Published
Issue
Section
License
Copyright (c) 2020 KNOWLEDGE KINGDOM PUBLISHING
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.