Doppler ultrasound and aspirin in recognition and prevention of pregnancy-induced hypertension.
Screening of 1226 nulliparous women by means of doppler uteroplacental flow-velocity waveforms in early pregnancy identified 148 (12%) as being at high risk of pregnancy-induced hypertension. After exclusions and refusals, 100 women were randomly allocated to groups receiving either low-dose aspirin (75 mg daily; 48 patients) or identical placebo (52 patients) for the remainder of the pregnancy. The difference between the aspirin and placebo groups in the frequency of pregnancy-induced hypertension (13% vs 25%) did not achieve significance, but there were significant differences in the frequencies of proteinuric hypertension (2% vs 19%) and hypertension occurring before 37 weeks' gestation (0% vs 17%). Fewer aspirin-treated than placebo-treated women had low birthweight babies (15% vs 25%), but this difference was not significant. The only perinatal death in the aspirin group followed a cord accident during labour, whereas the 3 perinatal deaths in the placebo group were all due to severe hypertensive disease. No maternal or neonatal side-effects were observed in either group.
McParland
P
P
Department of Obstetrics and Gynaecology, St George's Hospital Medical School, London, UK.
Pearce
J M
JM
Chamberlain
G V
GV
D000284:Administration, Oral; D000328:Adult; D001241:Aspirin / Q000008:administration & dosage* / Q000627:therapeutic use; D001792:Blood Platelets / Q000187:drug effects; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D011464:Epoprostenol / Q000037:antagonists & inhibitors; D005260:Female; D006801:Humans; D006973:Hypertension / Q000517:prevention & control*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000517:prevention & control*; D011262:Pregnancy Trimester, Second; D011507:Proteinuria / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013607:Tablets; D013931:Thromboxanes / Q000037:antagonists & inhibitors; D014463:Ultrasonography
D013607:Tablets; D013931:Thromboxanes; D011464:Epoprostenol; D001241:Aspirin