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Aspirin in pregnancy

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https://www.readbyqxmd.com/read/29024912/how-important-is-aspirin-adherence-when-evaluating-effectiveness-of-low-dose-aspirin
#1
REVIEW
Kate Navaratnam, Zarko Alfirevic, Munir Pirmohamed, Ana Alfirevic
Low-dose aspirin (LDA) is advocated for women at high-risk of pre-eclampsia, providing a modest, 10%, reduction in risk. Cardiology meta-analyses demonstrate 18% reduction in serious vascular events with LDA. Non-responsiveness to aspirin (sometimes termed aspirin resistance) and variable clinical effectiveness are often attributed to suboptimal adherence. The aim of this review was to identify the scope of adherence assessments in RCTs evaluating aspirin effectiveness in cardiology and obstetrics and discuss the quality of information provided by current methods...
October 3, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29024233/use-of-d-dimer-measurement-to-guide-anticoagulant-treatment-in-recurrent-pregnancy-loss-associated-with-antiphospholipid-syndrome
#2
Shi Hua Bao, Shi Le Sheng, Hong Liao, Qian Zhou, Sophia Twum Frempong, Wei Yan Tu
PROBLEM: To examine whether the level of plasma D-dimer can guide anticoagulant treatment in recurrent pregnancy loss (RPL) associated with antiphospholipid syndrome (APS). METHODS: A total of 1096 RPL women with APS between 2012 and 2015 in a single-center hospital were randomly divided into two groups (group A, 75 mg of low-dose aspirin [LDA] daily; group B, 75 mg of LDA plus 4100 U of low molecular weight heparin [LMWH] subcutaneously daily); 1015 of the total successfully completed the trial...
October 11, 2017: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/28974130/impact-of-early-supplementation-with-low-dose-aspirin-on-functional-first-trimester-parameters-in-low-risk-pregnancies
#3
Zvanca Mona Elena, Bot Mihaela, Radu Dan, Radu Nicoleta, Petca Aida
There is recent evidence that prophylaxis with 150 mg of aspirin given before 14-16 weeks significantly reduces preeclampsia rates and may improve pregnancy outcome. We conducted an observational study that investigates the effect of low-dose aspirin initiated early in pregnancy or in preconception on functional parameters assessed at 11-14 weeks.
October 3, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28948451/a-diagnostic-approach-to-stroke-in-young-adults
#4
REVIEW
Christopher A Stack, John W Cole
Optimal diagnosis and management of stroke in young adults benefit from a multidisciplinary team, including a vascular neurology specialist. In addition to the "standard" vascular risk factors including smoking, hypertension, diabetes, and hyperlipidemia, one needs to consider alternative etiologies including substance abuse, carotid/vertebral artery dissections, and rare genetic conditions among others. Once a young patient is determined to have had a stroke, the next question a clinician should ask is why did this patient have a stroke? A "heart to head" diagnostic approach is recommended...
September 25, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28921308/pregnancy-and-delivery-in-moyamoya-vasculopathy-experience-of-a-single-european-institution
#5
Güliz Acker, Marcus Czabanka, Peter Schmiedek, Peter Vajkoczy
Moyamoya vasculopathy (MMV) is a stenoocclusive cerebrovascular disease frequently affecting adolescent females. Thus, the management of pregnancy is of major interest for physicians dealing with MMV patients. However, clinical data concerning pregnant MMV patients is lacking. Our aim was to analyze the course of pregnancy in our European MMV patient cohort. We retrospectively identified MMV patients with a history of pregnancy who were treated in our institution. We analyzed demographic data, clinical symptoms, treatment, and detailed history of pregnancies...
September 18, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28917612/thyroid-stimulating-hormone-anti-thyroid-antibodies-and-pregnancy-outcomes
#6
Torie C Plowden, Enrique F Schisterman, Lindsey A Sjaarda, Neil J Perkins, Robert Silver, Rose Radin, Keewan Kim, Noya Galai, Alan H DeCherney, Sunni L Mumford
BACKGROUND: Overt thyroid dysfunction has been associated with adverse obstetric outcomes. However, less is known regarding subclinical hypothyroidism or thyroid autoimmunity and their relationship to pregnancy complications. OBJECTIVE: The purpose of this study was to examine the association between prepregnancy anti-thyroid antibodies and subclinical hypothyroidism and preterm delivery, gestational diabetes mellitus, and preeclampsia. STUDY DESIGN: We conducted a secondary analysis of a prospective cohort of 18- to 40-year-old women with 1-2 previous pregnancy losses (n=1193) who participated in a multicenter randomized, placebo-controlled trial of low-dose aspirin...
September 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28915160/current-insights-in-obstetric-antiphospholipid-syndrome
#7
Karen Schreiber, Massimo Radin, Savino Sciascia
PURPOSE OF REVIEW: Antiphospholipid syndrome (APS) is defined as the association of thrombotic events and/or obstetric morbidity in patients persistently positive for antiphospholipid antibodies (aPL). In this review, we will highlight the most important clinical presentations of APS with a focus on the obstetric morbidity, the current management strategies and the outlook for the future. RECENT FINDINGS: The use of aspirin and heparin has improved the pregnancy outcome in obstetric APS and approximately 70% of pregnant women with APS have a successful pregnancy outcome...
September 14, 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28913889/prevalence-and-contributors-to-low-grade-inflammation-in-three-u-s-populations-of-reproductive-age-women
#8
Lindsey A Sjaarda, Rose G Radin, Chandra Swanson, Daniel L Kuhr, Sunni L Mumford, Noya Galai, Robert M Silver, Jean Wactawski-Wende, Neil J Perkins, Enrique F Schisterman
BACKGROUND: Inflammation, measured by high-sensitivity C-reactive protein (hsCRP), is linked to adverse reproductive outcomes. However, prevalence and predictors of low-grade inflammation are poorly understood among reproductive age women. Therefore, the current aim was to characterize: (i) the prevalence of elevated hsCRP and (ii) whether the association of various demographic, anthropometric, life style, and metabolic characteristics with higher hsCRP varies across populations of reproductive age women with varying risk profiles for adverse reproductive outcomes...
September 15, 2017: Paediatric and Perinatal Epidemiology
https://www.readbyqxmd.com/read/28906358/efficacy-evaluation-of-low-dose-aspirin-in-ivf-icsi-patients-evidence-from-13-rcts-a-systematic-review-and-meta-analysis
#9
REVIEW
Liping Wang, Xiaman Huang, Xueli Li, Fang Lv, Xiao He, Yu Pan, Li Wang, Xiaomei Zhang
BACKGROUND: We conducted a systematic review and meta-analysis of existing literature to evaluate the different outcomes of low-dose aspirin on patients undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), including clinical pregnancy rate, implantation rate, live birth rate, miscarriage rate, fertilization rate, number of oocytes retrieved, and so forth. METHODS: Electronic databases including PubMed, MEDLINE, and Embase were searched between 1997 and March 2016 to identity eligible studies...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28888591/aspirin-for-evidence-based-preeclampsia-prevention-trial-influence-of-compliance-on-beneficial-effect-of-aspirin-in-prevention-of-preterm-preeclampsia
#10
David Wright, Liona C Poon, Daniel L Rolnik, Argyro Syngelaki, Juan Luis Delgado, Denisa Vojtassakova, Mercedes de Alvarado, Evgenia Kapeti, Anoop Rehal, Andrea Pazos, Ilma Floriana Carbone, Vivien Dutemeyer, Walter Plasencia, Nikos Papantoniou, Kypros H Nicolaides
BACKGROUND: The Aspirin for Evidence-Based Preeclampsia Prevention trial was a multicenter study in women with singleton pregnancies. Screening was carried out at 11-13 weeks' gestation with an algorithm that combines maternal factors and biomarkers (mean arterial pressure, uterine artery pulsatility index, and maternal serum pregnancy-associated plasma protein A and placental growth factor). Those with an estimated risk for preterm preeclampsia of >1 in 100 were invited to participate in a double-blind trial of aspirin (150 mg/d) vs placebo from 11-14 until 36 weeks' gestation...
September 6, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28887883/early-screening-and-prevention-of-preterm-preeclampsia-with-aspirin-time-for-clinical-implementation
#11
EDITORIAL
Daniel L Rolnik, Neil O'Gorman, Stephanie Roberge, Emmanuel Bujold, Jonathan Hyett, Serge Uzan, Michel Beaufils, Fabricio da Silva Costa
Despite all the research published in the last three decades on screening and prevention of preeclampsia (PE), this condition remains one of the main causes of maternal and perinatal morbidity and mortality, both in low and high-income countries. It affects 2-8% of all pregnancies, being responsible for one out of five maternal deaths and 15% of all premature deliveries(1) . An ideal screening test requires identification of women at high-risk of developing severe and early-onset forms of the disease, a high detection rate (DR) with an acceptable false-positive rate (FPR), and the availability of an effective preventive measure(2) ...
September 9, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28880908/prostacyclin-thromboxane-and-glomerular-filtration-rate-are-abnormal-in-sickle-cell-pregnancy
#12
Opeyemi Abayomi Obilade, Alani Suleimon Akanmu, Fiona Broughton Pipkin, Bosede Bukola Afolabi
BACKGROUND: Pregnancy increases the risk of morbidity and mortality in sickle cell disease. We previously showed pregnant women with sickle cell disease to have a relatively low plasma renin concentration in late pregnancy, associated with a lack of the expected plasma volume expansion. We hypothesized this to be due to increased systemic vascular resistance through an imbalance between the vasodilator prostacyclin and vasoconstrictor thromboxane, associated with decreased glomerular filtration rate (GFR)...
2017: PloS One
https://www.readbyqxmd.com/read/28853115/effects-of-mandatory-screening-labs-in-directing-the-disposition-of-the-apparently-healthy-psychiatric-patient-in-the-emergency-department
#13
Karyn E Kagel, Meghan Smith, Ilya V Latyshenko, Christopher Mitchell, Andrew Kagel
OBJECTIVE: To determine whether mandatory psychiatric admission laboratory tests yield results that change the disposition of a patient with primary psychiatric complaint from admission to a psychiatric service to admission to a medical service. METHODS: This was a single center retrospective cohort chart review study approved by the facility Institutional Review Board in which we used a records database maintained by the emergency department's social workers to access the records of every patient that presented to our emergency department with a psychiatric chief complaint between the dates of December 1, 2011, and December 1, 2013...
July 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/28837832/factors-associated-with-adverse-pregnancy-outcomes-in-women-with-antiphospholipid-syndrome-a-multicenter-study
#14
Masashi Deguchi, Hideto Yamada, Mayumi Sugiura-Ogasawara, Mamoru Morikawa, Daisuke Fujita, Akinori Miki, Shintaro Makino, Atsuko Murashima
The aim of this study was to understand the clinical features of antiphospholipid syndrome (APS)-complicated pregnancies and evaluate risk factors for the adverse pregnancy outcomes. This multicenter study evaluated live-birth rates according to therapy modality for APS and risk factors of pregnancy loss in 81 pregnancies. Risk factors for pregnancy complications, including premature delivery before 34 gestational weeks, hypertensive disorders of pregnancy, thrombocytopenia, and light-for-date neonate, were evaluated in 51 women who received low dose aspirin (LDA) plus unfractionated heparin (UFH) and delivered after 24 GW...
August 4, 2017: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/28820406/-results-of-preparation-and-implementation-of-ivf-program-in-patients-with-thrombophilia-and-history-of-failed-ivf
#15
G Abrahamyan
The problem of infertility and reproductive losses maintains its urgency, as well as medical and social significance. Frequency of infertility in overall population, according to the data from different authors, varies from 9 to 18 per cent. Methods of aided reproductive technologies (ART) opened a new era in the field of correction of infertile marriage. As a result, more and more couples choose to solve this problem by means of aided reproductive technologies (ART): in-vitro fertilization (IVF) and embryo transfer (ET)...
July 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28804023/association-of-serum-autoantibodies-with-pregnancy-outcome-of-patients-undergoing-first-ivf-icsi-treatment-a-prospective-cohort-study
#16
Xian Chen, Mei-Lan Mo, Chun-Yu Huang, Liang-Hui Diao, Guan-Gui Li, Yu-Ye Li, Aaron Lerner, Yehuda Shoenfeld, Yong Zeng
The relevance of antiphospholipid (aPL), antinuclear (ANA) or antithyroid (ATA) antibodies in women undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) are controversial. The present study aims to investigate which autoantibodies are associated with the pregnancy outcome of patients undergoing first IVF/ICSI treatment. A total of 3763 IVF/ICSI patients were recruited from January to December 2015. Forty-five patients positive for aPL presenting adverse outcomes in their first cycle received low-dose aspirin treatment before the second transfer...
August 3, 2017: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/28793357/preeclampsia
#17
José Geraldo Lopes Ramos, Nelson Sass, Sérgio Hofmeister Martins Costa
The authors review hypertensive disease during pregnancy with an academic and practical view, and using the best evidence available. This disease, which is the most important clinical disease in Brazilian pregnant women, may have its incidence reduced with prevention through the use of calcium and aspirin in pregnant women at risk. Previously, it was a disease that presented with hypertension with proteinuria, but it has now been classified with new clinical parameters besides proteinuria. Morbidity and mortality should be reduced in a continental country such as Brazil using protocols for the early treatment of complications by calculating severe outcomes in preeclampsia...
September 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28741785/aspre-trial-performance-of-screening-for-preterm-pre-eclampsia
#18
D L Rolnik, D Wright, L C Y Poon, A Syngelaki, N O'Gorman, C de Paco Matallana, R Akolekar, S Cicero, D Janga, M Singh, F S Molina, N Persico, J C Jani, W Plasencia, G Papaioannou, K Tenenbaum-Gavish, K H Nicolaides
OBJECTIVE: To examine the performance of screening for preterm and term pre-eclampsia (PE) in the study population participating in the ASPRE (Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence-Based Preeclampsia Prevention) trial. METHODS: This was a prospective first-trimester multicenter study on screening for preterm PE in 26 941 singleton pregnancies by means of an algorithm that combines maternal factors, mean arterial pressure, uterine artery pulsatility index and maternal serum pregnancy-associated plasma protein-A and placental growth factor at 11-13 weeks' gestation...
October 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28705190/low-dose-aspirin-in-the-prevention-of-recurrent-spontaneous-preterm-labour-the-april-study-a-multicenter-randomized-placebo-controlled-trial
#19
Laura Visser, Marjon A de Boer, Christianne J M de Groot, Tobias A J Nijman, Marieke A C Hemels, Kitty W M Bloemenkamp, Judith E Bosmans, Marjolein Kok, Judith O van Laar, Marieke Sueters, Hubertina Scheepers, Joris van Drongelen, Maureen T M Franssen, J Marko Sikkema, Hans J J Duvekot, Mireille N Bekker, Joris A M van der Post, Christiana Naaktgeboren, Ben W J Mol, Martijn A Oudijk
BACKGROUND: Preterm birth (birth before 37 weeks of gestation) is a major problem in obstetrics and affects an estimated 15 million pregnancies worldwide annually. A history of previous preterm birth is the strongest risk factor for preterm birth, and recurrent spontaneous preterm birth affects more than 2.5 million pregnancies each year. A recent meta-analysis showed possible benefits of the use of low dose aspirin in the prevention of recurrent spontaneous preterm birth. We will assess the (cost-)effectiveness of low dose aspirin in comparison with placebo in the prevention of recurrent spontaneous preterm birth in a randomized clinical trial...
July 14, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28698954/principles-of-first-trimester-screening-in-the-age-of-non-invasive-prenatal-diagnosis-screening-for-other-major-defects-and-pregnancy-complications
#20
REVIEW
Karl Oliver Kagan, Jiri Sonek, Philipp Wagner, Markus Hoopmann
PURPOSE: First trimester risk assessment plays a major role in the contemporary pregnancy care. It has evolved significantly since its introduction in the 1990s when it essentially consisted of just the nuchal translucency measurement. Today, it involves the measurement of several biophysical and biochemical markers and can assess the risk for a wide array of major chromosomal and non-chromosomal defects as well as other pregnancy-related complications. METHODS: A search of the Medline and Embase databases was done looking for articles about first trimester screening...
July 11, 2017: Archives of Gynecology and Obstetrics
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