The incidence of three or more consecutive pregnancy losses in the first or early second trimester of pregnancy (less than 20 weeks of gestation) is known as recurrent pregnancy loss or RPL. One theory of pregnancy is that it is an oxidative stress condition brought on by increased placental mitochondrial synthesis and activity. When a burst of oxidative stress coincides with the formation of blood flow into the intervillous region during the first trimester, excessive ROS generation may result.
Furthermore, research has demonstrated that ROS in IVF culture media may have an impact on the development of embryos after fertilisation. Early pregnancy loss could be influenced by the incapacity to develop a strong antioxidant defense against this. This article can provide a solution to the question of can pregnant women take acetylcysteine drug (nac คนท้องกินได้ไหม, this is the term in Thai)?
N-Acetylcysteine
NAC is a mucolytic medication that is well-tolerated, safe, and softens tenacious discharges of mucus. It is both of their acetylated precursors. L-cysteine and reduced glutathione are amino acids. NAC protects mice from methyl mercury embryotoxicity, according to research on experimental animals.
Furthermore, in rat embryo culture, it inhibits the teratogenic impact of diabetes serum. In a randomized controlled experiment, NAC medication did not successfully stabilize pre-eclamptic toxaemia in humans, however, the research revealed no adverse effects on either the mother or the fetus from NAC treatment. Furthermore, a recent study that demonstrated the possible advantages of NAC co-treatment in individuals with persistent anovulation brought attention to its significance for human reproduction. NAC’s potential application in treating patients with unexplained RPL has never been investigated. The purpose of one specific study was to evaluate the impact of folic acid alone versus NAC + folic acid supplementation on pregnancy outcomes in patients with unexplained RPL.
Patients with RPL
Patients with a history of inexplicable RPL showed a significant lengthening of gestation while receiving NAC treatment. Increased oxidative stress, angiogenesis, and apoptosis are only a few of the biochemical events that have been linked to miscarriage and pregnancy. However, in a healthy pregnancy, modifications take place in the peripheral circulation that provide defense against the damaging effects of free radicals. Research has demonstrated a correlation between oxidative stress and fetal injury and glutathione depletion. Moreover, it might cause apoptosis, the effects of which NAC’s antioxidant qualities might mitigate.
Additionally, it is probable that RPL is linked to decreased expression of genes related to angiogenesis and apoptosis.
Probable effects of NAC on pregnancy
One great source of sulphydryl groups is NAC. It is a thiol-containing antioxidant that functions as a direct free radical scavenger or raises intracellular glutathione concentrations. By preserving intracellular glutathione concentrations and lowering mitochondrial membrane depolarization, NAC was discovered to inhibit apoptosis and oxygen-related genotoxicity in endothelial cells. It inhibits the DNA-binding activity of nuclear factors and the ensuing gene expression.
Additionally, it prevents the release of pro-inflammatory cytokines and the metabolism of phospholipids. Thus, in both normal and aberrant pregnancy, NAC may alter oxidative stress, angiogenesis, and responses prompted by apoptosis. A study discovered that giving individuals with unexplained RPL NAC + folic acid greatly enhanced pregnancy viability to 20 weeks of pregnancy. A higher take-home baby rate in the NAC-treated patient group demonstrated this beneficial impact. This positive reaction to NAC might be explained by the biological effects that were previously stated.