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. 2018 Oct;68(5):382-388.
doi: 10.1007/s13224-017-1058-4. Epub 2017 Nov 7.

Role of Aspirin in High Pulsatility Index of Uterine Artery: A Consort Study

Nidhi Sharma  1   2 , Sunayana Srinivasan  3 , K Jayashree Srinivasan  1 , Kulasekaran Nadhamuni  1
Affiliations

Role of Aspirin in High Pulsatility Index of Uterine Artery: A Consort Study

Nidhi Sharma et al. J Obstet Gynaecol India. 2018 Oct.

Abstract

Background: Preeclampsia is a heterogeneous disorder prevalent in 3-10% of pregnant women globally. The etiology is multifactorial. There is a initial stage of endothelial dysfunction and placental ischemia (Stage 1); this leads to maternal syndrome of hypertension, edema, and proteinuria (Stage 2). Drugs acting on immunomodulatory, anti-inflammatory, antioxidant and proresolving pathways can minimize the complications of preeclampsia. The therapeutic effect of aspirin is based on acetyl group and salicylate group. Both components have independent therapeutic effects on anti-inflammatory pathway and proresolving pathway.

Aims and objectives: This study was designed to assess the effectiveness and safety of aspirin in prevention and treatment of symptoms and complications of preeclampsia in women at high risk of preeclampsia.

Methods: This is a prospective experimental study to evaluate the effectiveness of aspirin versus placebo in the prevention of maternal syndrome of preeclampsia in women with high risk of preeclampsia (G1 = 97, G2 = 92). Patients with age ≥ 34, chronic hypertension, multiple pregnancies, gestational diabetes, and high pulsatility index of uterine artery were enrolled between 12 and 20 weeks of gestation and prescribed 75 mg aspirin daily till 34 weeks of gestation. Control group was not prescribed aspirin.

Observations and results: There was a reduction in relative risk of preeclampsia in aspirin group as compared with control group. There was no significant increase in the number of cases of abruption placenta, preterm delivery, neonatal intraventricular hemorrhage, patent ductus arteriosus, and postpartum hemorrhage following aspirin therapy.

Conclusion: In patients with high mean pulsatility index of uterine arteries, low dose aspirin can be a useful intervention. Uterine artery Doppler is a simple and noninvasive test which can be used safely for the prediction of preeclampsia. Aspirin is safe, economical, and easily available commercially.

Keywords: Acetylsalicylic acid; Doppler; Preeclampsia; Ultrasound; Uterine artery.

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Conflict of interest statement

The authors declare that there is no conflict of interest. We do not have any commercial association that might pose a conflict of interest in connection with the manuscript. We certify that neither this manuscript nor one with substantially similar content under our authorship has been published or is being considered for publication elsewhere.Ethical Committee approval was obtained from the Institutional Research Board.The research participants were informed about the study in local language and informed written consent was taken after explaining the nature of ultrasound Doppler scan in pregnancy. We have obtained the patient’s consent for participation in research. Ethical committee clearance and research board clearance was obtained for this study according to the Principle of Helsinki.

Figures

Fig. 1
Fig. 1
Consort flow diagram of the study
Fig. 2
Fig. 2
a Case group (G1): base line characteristics of pregnant women at high risk started on aspirin. b Control group (G2): base line characteristics of pregnant women at high risk not started on aspirin
See this image and copyright information in PMC

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