A novel approach to the management of pregnancies complicated by uteroplacental insufficiency and previous stillbirth.
To our knowledge, this is the first time that a combination of aspirin and glyceryl trinitrate (GTN) has been used in the prophylaxis of preeclampsia and fetal growth retardation, and their use associated with not only Doppler screening of the uterine arteries but also regular Doppler follow-up of the fetal arterial and venous circulation. Whilst future trials are needed to prove whether screening, prophylaxis and Doppler management are individually beneficial, we propose that this combination of management strategies contributed to a good outcome in the cases described. Furthermore, randomized trials are required to determine the safety and efficacy of prophylactic low-dose aspirin combined with GTN treatment in pregnancies affected by an impaired uteroplacental circulation.
Oyelese
K O
KO
Department of Obstetrics and Gynaecology, St George's Hospital Medical School, London, United Kingdom.
Black
R S
RS
Lees
C C
CC
Campbell
S
S
D000328:Adult; D001241:Aspirin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005313:Fetal Death; D005317:Fetal Growth Retardation / Q000517:prevention & control*; D005323:Fetal Monitoring; D006801:Humans; D005996:Nitroglycerin / Q000627:therapeutic use*; D021041:Placental Circulation; D010927:Placental Insufficiency; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011225:Pre-Eclampsia / Q000517:prevention & control*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014665:Vasodilator Agents / Q000627:therapeutic use*
D010975:Platelet Aggregation Inhibitors; D014665:Vasodilator Agents; D005996:Nitroglycerin; D001241:Aspirin