Low dose acetylsalicylic acid in prevention of pregnancy-induced hypertension and intrauterine growth retardation in women with bilateral uterine artery notches.
OBJECTIVE
To evaluate the efficacy of low-dose acetylsalicylic acid in the prevention of pregnancy-induced hypertension and intrauterine growth retardation in high-risk pregnancies as determined by transvaginal Doppler ultrasound study of the uterine arteries at 12 to 14 weeks of gestation.


METHODS
Randomised, double blind and placebo-controlled trial.


METHODS
The Department of Obstetrics and Gynaecology, Tampere University Hospital, Finland.


METHODS
One hundred and twenty pregnant women considered to be at high risk of pre-eclampsia or intrauterine growth retardation were screened by transvaginal Doppler ultrasound at 12 to 14 weeks of gestation.


METHODS
Ninety pregnant women with bilateral notches in the uterine arteries were randomised to receive acetylsalicyclic acid 0.5mg/kg/day (n = 45) or placebo (n = 45) from 12 to 14 weeks of gestation.


METHODS
Hypertensive disorders of pregnancy and intrauterine growth retardation.


RESULTS
Forty-three women on acetylsalicyclic acid and 43 on placebo were successfully followed up. The use of acetylsalicyclic acid was associated with a statistically significant reduction in the incidence of pregnancy-induced hypertension (11.6% vs 37.2%, RR = 0.31, 95% CI 0.13-0.78) and pre-eclampsia (4.7% vs 23.3%, RR = 0.2, 95% Cl 0.05-0.86). The incidence of hypertension before 37 weeks of pregnancy was also significantly reduced (2.3% vs 20.9%, RR = 0.22, 95% CI 0.05-0.97). The reduction in the incidence of intrauterine growth retardation (2.3% vs 7%) was not statistically significant. Acetylsalicyclic acid was not associated with excess risk of maternal or fetal bleeding.


CONCLUSIONS
In women rated in Doppler velocimetry waveform analysis to be at high risk of pre-eclampsia, low-dose acetylsalicyclic acid reduces the incidence of pregnancy-induced hypertension and especially proteinuric pre-eclampsia.
Vainio
Merja
M
Department of Obstetrics and Gynaecology Tampere University Hospital, Finland.
Kujansuu
Erkki
E
Iso-Mustajärvi
Marja
M
Mäenpää
Juhani
J
D000328:Adult; D001158:Arteries; D001241:Aspirin / Q000008:administration & dosage*; D001724:Birth Weight; D001783:Blood Flow Velocity; D004311:Double-Blind Method; D005260:Female; D005317:Fetal Growth Retardation / Q000517:prevention & control*; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D006973:Hypertension / Q000517:prevention & control*; D011225:Pre-Eclampsia / Q000517:prevention & control; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000517:prevention & control*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011446:Prospective Studies; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014599:Uterus / Q000098:blood supply*
D005343:Fibrinolytic Agents; D001241:Aspirin