Aspirin in the prevention of preeclampsia and associated maternal and perinatal complications
Background. The issues of preeclampsia prevention are the focus of attention of biomedical researchers. This is primarily due to the fact that in addition to their negative impact on maternal and perinatal morbidity and mortality, the consequences of this great obstetric syndrome reduce the quality of subsequent life of women. Therefore, the early detection of pregnant women having a high risk for preeclampsia (PE) and its effective preventive interventions are of great sociomedical importance. Recent randomized controlled trials and meta-analyses provide reliable evidence demonstrating the efficacy of aspirin in women at high risk for PE and associated placental disorders, the basis for which is abnormal placentation: fetal growth restriction (FGR) and preterm birth.Khodzhaeva Z.S., Kholin A.M., Chulkov V.S., Muminova K.T.
Objective. To generalize and actualize the existing data on the efficacy of low-dose aspirin in preventing PE and associated complications in the target patient group; on the optimal dose of aspirin; on gestational ages at the beginning and end of this therapy to achieve the maximum efficiency and to minimize possible side effects.
Material and methods. The review includes data from priority publications over the past 5–7 years on the use of aspirin to prevent preeclampsia and other placenta-related pregnancy complications.
Results. The results suggest that aspirin taken at 16 weeks of pregnancy until 36 weeks has a favorable effect, which should be taken into account when developing clinical protocols and recommendations.
Conclusion. The analysis of priority publications strongly demonstrated the benefits of the intake of low-dose aspirin (80–150 mg) in the evening (at bedtime), which was started at 16 weeks of gestation and continued until 36 weeks in order to reduce the risk of severe and premature PE, FGR, preterm birth, and perinatal mortality in the target group of pregnant women, which was identified from extended combined first-trimester screening results.
Keywords
aspirin
preeclampsia
fetal growth restriction
preeclampsia prevention
preeclampsia prediction
combined first-trimester screening
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Received 08.09.2017
Accepted 22.09.2017
About the Authors
Khodzhaeva, Zulfiya S., M.D., Ph.D., Professor, Head of Maternal-Fetal Depaertment, National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: z_khodzhaeva@oparina4.ruKholin, Alexey M., Researcher, 1st obstetric department of pregnancy pathology, Department of Ultrasound and Functional Diagnostics,
National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: a_kholin@oparina4.ru
Chulkov, Vasiliy, M.D., Ph.D., Assistant Professor, Department of Faculty Therapy, South Ural State Medical University. E-mail: v_chulkov@mail.ru
Muminova, Kamilla, research fellow, Department of Maternal Fetal Medicine, National Medical Research Center of Obstetrics, Gynecology and Perinatology named
after Academician V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: k_muminova@oparina4.ru
For citations: Khodzhaeva Z.S., Kholin A.M., Chulkov V.S., Muminova K.T. Aspirin in the prevention of preeclampsia and associated maternal and perinatal complications. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (8): 12-8. (in Russian)
https://dx.doi.org/10.18565/aig.2018.8.12-18
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