48: Effect of obesity on platelet inhibition in high-risk pregnant women treated with low dose aspirin

Background: Though pregnancy induced hypertension is a worldwide problem, it is more prevalent in developing countries particularly south east Asian and African countries. It contributes to 20% of perinatal death and 40-50% of low birth weight babies in India. Fetal salvage is also an important consideration in providing quality care. Low dose aspirin given between 12 weeks to 28 weeks of gestational age in high-risk women at Developing Pregnancy Induced Hypertension (PIH) is anticipated to prevent the development of PIH and complications that arises especially those regarding maternal and fetal mortality due to PIH.Methods: This prospective randomized controlled trial was conducted in the dept of O and G, SCB MC and Hospital, Cuttack during November 2018 to October 2019. Pregnant women between the gestational age of 13 to 28 week were screened for risk factors and included in this study. Low dose aspirin of 60 mg daily till delivery was given to pregnant women who consented to be a part of study randomly with the other group taking placebo.Results: Incidence of IUGR babies in low dose aspirin treated mothers was as low as 1%. Incidence of LBW babies is lower in low dose aspirin treated mothers than with those who were not treated. Mean birth weight in cases was 2780 gm±352 gm vs control 2592 gm±483 gm. There is increased incidence of still birth in high risk group not treated with aspirin. No significant difference in reducing incidence premature deliveries between case and control.Conclusions: Low dose aspirin has a definite role in the prevention of PIH in high risk pregnancy and its complication like IUGR and low birth weight. Low dose aspirin reduces the incidence of PIH. Low dose aspirin can be considered a safe drug without any deleterious side effect for mother and the fetus. Benefits of prevention of PIH, justifies its administration in women at high risk.

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Effect of low dose aspirin on maternal outcome in women at risk for developing pregnancy induced hypertension

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20201229 ◽

2020 ◽

Vol 9 (4) ◽

pp. 1590

Author(s):

Madhusmita Pradhan ◽

Kishore S. V. ◽

Jyotiranjan Champatiray

Keyword(s):

Risk Factors ◽

High Risk ◽

Pregnant Women ◽

Low Dose ◽

Multiple Pregnancy ◽

Control Group ◽

Pregnancy Induced Hypertension ◽

Dose Aspirin ◽

Low Dose Aspirin ◽

Induced Hypertension

Background: Pre-eclampsia is not totally a preventable disease. It is found more related to chains of social ills such as poor maternal nutrition, limited or no antenatal care and poor reproductive education. However, some specific “high-risk” factors leading to pregnancy induced hypertension (PIH) may be identified in individuals which include and not limited to young and elderly primigravida, multiple pregnancy, diabetes, Rh incompatibility, new paternity, pre-existing vascular or renal disease, family history of hypertension, pre-eclampsia and eclampsia, obesity, thrombophilia. Low dose aspirin given in 2nd trimester in these high-risk women is anticipated to prevent the development of PIH.Methods: This prospective randomized controlled trial was conducted in the department of obstetrics and gynecology, SCB MC and Hospital, Cuttack during November 2018 to October 2019. Pregnant women between the gestational age of 13th to 28th weeks were screened for risk factors and included in this study. Low dose aspirin of 60 mg daily till delivery was given to pregnant women who consented to be a part of study randomly with the other group having placebo.Results: Protienuric hypertension was high in control group who did not receive aspirin. Low dose aspirin significantly reduces PIH in high-risk group (3.48% in case versus 23.52% in control). Low dose aspirin was not associated with significant increase in placental bleeding. Low dose aspirin was generally safe for the fetus and new born infant with no evidence of an increased likelihood of bleeding.Conclusions: Low dose aspirin has a definite role in the prevention of PIH in high risk pregnancy. Low dose aspirin reduces the incidence of PIH. Low dose aspirin can be considered a safe drug without any deleterious side effect for mother and the fetus. Benefits of prevention of PIH, justifies its administration in women at high risk.

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Impact of educational preeclampsia prevention booklet on knowledge and adherence to low dose aspirin among pregnant women with high risk for preeclampsia

Journal of Basic and Clinical Physiology and Pharmacology ◽

10.1515/jbcpp-2019-0299 ◽

2020 ◽

Vol 30 (6) ◽

Author(s):

Rella Indah Karunia ◽

Anita Purnamayanti ◽

Fransiscus O.H. Prasetyadi

Keyword(s):

High Risk ◽

Pregnant Women ◽

Low Dose ◽

P Value ◽

Dose Aspirin ◽

Validated Questionnaire ◽

Low Dose Aspirin ◽

Significant Difference ◽

Before And After ◽

The Impact

AbstractBackgroundPostpartum bleeding and pregnancy induced hypertension – including preeclampsia – remain to be a great cause of maternal mortality. The use of aspirin for preventing preeclampsia has been practiced recently by fetomaternal specialists in Indonesia. This study aimed to analyze the impact of education using an aspirin booklet provided by pharmacists on knowledge and adherence in taking aspirin among pregnant women with high risk for preeclampsia.MethodsThis was one group of pretest-posttest study. We enrolled all pregnant women with high risk for preeclampsia screened at 11+0–13+6 weeks’ gestation at Fetomaternal Clinic, Dr. Ramelan Naval Hospital, Surabaya. All subjects prescribed with low-dose aspirin (100 mg) for preeclampsia prevention received oral and written education using the aspirin booklet and had been followed up for 2 months. Knowledge about aspirin for preeclampsia prevention was measured by a validated questionnaire developed for this study. Adherence to aspirin was measured by pill count method.ResultsA total of 12 pregnant women with high risk for preeclampsia were included during the study period. This study showed a statistically significant difference on knowledge of preeclampsia prevention before and after receiving oral and written education using aspirin booklet (p-value = 0.020), as well as aspirin adherence (p-value = 0.011).ConclusionThe use of oral education and written aspirin booklet provided by pharmacists had impact on knowledge of preeclampsia prevention and adherence in taking aspirin among pregnant women with high risk for preeclampsia. We recommend to conduct randomized control study of adequate number of subjects.

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A Promising Effect of Pravastatin For Reducing Preeclamsia Incidence In High Risk Pregnant Women

International Islamic Medical Journal ◽

10.33086/iimj.v1i1.1385 ◽

2019 ◽

Vol 1 (1) ◽

pp. 1-8

Author(s):

Fariska Zata ◽

Mohammad Nasir

Keyword(s):

Cardiovascular Disease ◽

High Risk ◽

Pregnant Women ◽

Low Dose ◽

Early Prevention ◽

Dose Aspirin ◽

Low Dose Aspirin ◽

Definitive Therapy ◽

History Of

Preeclamsia is still a threat in obstetrics because it is the leading cause of maternal death (15-20% in developing countries). Globally, preeclampsia causes 70,000-80,000 pregnant women to die and 500,000 babies die annually1, with increased morbidity such as prematurity and fetal growth disturbance2. The exact cause of preeclampsia is still not clearly known (also called "The disease of theory"), but recent studies shows that the imbalance of pro-angiogenic (VEGF, PlGF) and anti-angiogenic factors (sFlt-1, s-Eng) plays an important role in the pathogenesis preeclampsia. The presence of general maternal endothelial dysfunction induced by an imbalance of these factors is a major phenomenon in preeclampsia, which results in placental hypoxia / ischemia, resulting in vasoconstriction resulting in hypertension1. Termination of pregnancy is still as a definitive therapy for preeclamsia. Therefore, early prevention is necessary in the management of preeclampsia. In 2013, ACOG recommended the administration of low-dose aspirin and calcium 1 gram / day to patients in pregnant women with high risk of preeclamsia3. However, low-dose aspirin is less useful in preventing preeclampsia in patients with a history of previous chronic hypertension4 and not reduce the incidence of term preeclampsia (the incidence of preeclampsia at gestational age above 37 weeks)5,6. This weakness of low-dose aspirin has led to recent research focusing on the prevention of preeclampsia. The similarity between the pathogenesis mechanism of preeclampsia and cardiovascular disease makes pravastatin (a protective therapy in cardiovascular disease before) as a potential agent for preventing preeclampsia7. Therefore, the role of pravastatin for reducing preeclampsia incidence in high risk pregnant women will be discussed in this article.

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