Angiotensin sensitivity predicts aspirin benefit in placental insufficiency.
OBJECTIVE
To determine whether the beneficial effects of aspirin in the treatment of Doppler umbilical placental insufficiency correlate with the maternal pressor response to angiotensin infusion.


METHODS
An open trial.


METHODS
A tertiary referral obstetric service.


METHODS
Women identified at between 25 and 36 weeks of pregnancy with an elevated umbilical artery Doppler systolic/diastolic (S/D) ratio and a positive pressor response to angiotensin infusion.


METHODS
Low dose aspirin (100mg/day) treatment of mothers.


METHODS
Fetal and placental size at delivery in relation to subsequent maternal angiotensin responsiveness.


RESULTS
Women who converted from a positive angiotensin pressor response to angiotensin refractoriness after aspirin administration had larger infants and placentas compared with those whose response remained positive.


CONCLUSIONS
Angiotensin sensitivity predicts women with umbilical Doppler detected placental insufficiency responding to aspirin therapy. Loss of the normal refractory response in pregnancy may be a consequence of vascular pathology in the placenta.
Cook
C M
CM
Trudinger
B J
BJ
D000809:Angiotensins / Q000378:metabolism*; D001241:Aspirin / Q000627:therapeutic use*; D005260:Female; D005317:Fetal Growth Retardation; D006801:Humans; D010927:Placental Insufficiency / Q000188:drug therapy* / Q000378:metabolism; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors
D000809:Angiotensins; D001241:Aspirin