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Aspirin in pregnancy

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https://www.readbyqxmd.com/read/28820406/-results-of-preparation-and-implementation-of-ivf-program-in-patients-with-thrombophilia-and-history-of-failed-ivf
#1
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/28793357/preeclampsia
#2
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...
August 9, 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28741785/aspre-trial-performance-of-screening-for-preterm-pre-eclampsia
#3
Daniel L Rolnik, David Wright, Liona C Poon, Argyro Syngelaki, Neil O'Gorman, Catalina de Paco Matallana, Ranjit Akolekar, Simona Cicero, Deepa Janga, Mandeep Singh, Francisca S Molina, Nicola Persico, Jacques C Jani, Walter Plasencia, George Papaioannou, Kinneret Tenenbaum-Gavish, Kypros 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...
July 25, 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
#4
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
#5
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
https://www.readbyqxmd.com/read/28691359/chronic-histiocytic-intervillositis-in-three-consecutive-pregnancies-in-a-single-patient-differing-clinical-results-and-pathology-according-to-treatment-used
#6
Nobuaki Ozawa, Koushi Yamaguchi, Megumi Shibata, Rika Sugibayashi, Hiroya Yagi, Haruhiko Sago, Kentaro Matsuoka
Chronic histiocytic intervillositis (CHI) is an extremely rare pathological condition but is strongly associated with severe obstetric complications and has a high recurrence rate. The management of this condition has not yet been established. We describe herein the occurrence of CHI in the late second-third trimester in each of three consecutive pregnancies in a single patient with four previous consecutive early miscarriages. In this patient, each of the three complicated pregnancies was managed with one of the following, respectively: low-dose aspirin; heparin plus low-dose aspirin; and prednisolone plus low-dose aspirin...
July 10, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28657417/aspirin-versus-placebo-in-pregnancies-at-high-risk-for-preterm-preeclampsia
#7
Daniel L Rolnik, David Wright, Liona C Poon, Neil O'Gorman, Argyro Syngelaki, Catalina de Paco Matallana, Ranjit Akolekar, Simona Cicero, Deepa Janga, Mandeep Singh, Francisca S Molina, Nicola Persico, Jacques C Jani, Walter Plasencia, George Papaioannou, Kinneret Tenenbaum-Gavish, Hamutal Meiri, Sveinbjorn Gizurarson, Kate Maclagan, Kypros H Nicolaides
Background Preterm preeclampsia is an important cause of maternal and perinatal death and complications. It is uncertain whether the intake of low-dose aspirin during pregnancy reduces the risk of preterm preeclampsia. Methods In this multicenter, double-blind, placebo-controlled trial, we randomly assigned 1776 women with singleton pregnancies who were at high risk for preterm preeclampsia to receive aspirin, at a dose of 150 mg per day, or placebo from 11 to 14 weeks of gestation until 36 weeks of gestation...
August 17, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28651448/adverse-pregnancy-outcomes-in-deliveries-prior-to-at-and-beyond-39%C3%A2-weeks-low-and-high-risk-women
#8
Hind N Moussa, Susan Hosseini Nasab, Farah H Amro, Jennifer Hoayek, Ziad A Haidar, Sean C Blackwell, Baha M Sibai
BACKGROUND: Hypertensive disorders are associated with maternal and neonatal complications. Though they are more common in women with history of prior preeclampsia, they can occur in uncomplicated pregnancies. OBJECTIVE: To determine the proportion of adverse pregnancy outcomes in deliveries prior to or at ≥39 weeks, in uncomplicated singleton nulliparous women (low-risk), as well as women with history of preeclampsia in a prior gestation (high-risk). STUDY DESIGN: This was a secondary analysis from the multicenter trials of low dose aspirin for preeclampsia prevention in low and high-risk pregnancies...
June 26, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28619690/metformin-the-aspirin-of-the-21st-century-its%C3%A2-role-in-gestational-diabetes-mellitus-prevention-of-preeclampsia-and-cancer-and%C3%A2-the-promotion-of-longevity
#9
REVIEW
Roberto Romero, Offer Erez, Maik Hüttemann, Eli Maymon, Bogdan Panaitescu, Agustin Conde-Agudelo, Percy Pacora, Bo Hyun Yoon, Lawrence I Grossman
Metformin is everywhere. Originally introduced in clinical practice as an antidiabetic agent, its role as a therapeutic agent is expanding to include treatment of prediabetes mellitus, gestational diabetes mellitus, and polycystic ovarian disease and, more recently, experimental studies and observations in randomized clinical trials suggest that metformin could have a place in the treatment or prevention of preeclampsia. This article provides a brief overview of the history of metformin in the treatment of diabetes mellitus, reviews the results of metaanalyses of metformin in gestational diabetes mellitus, and the treatment of obese non-diabetic pregnant women to prevent macrosomia...
June 12, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28599894/impact-of-aspirin-on-fetal-growth-in-diabetic-pregnancies-according-to-white-classification
#10
Katlynn Adkins, Amanda A Allshouse, Torri D Metz, Kent D Heyborne
BACKGROUND: Current US Preventive Services Task Force and other guidelines recommend low-dose aspirin for all pregnant women with pregestational diabetes mellitus to prevent preeclampsia and small-for-gestational-age birth. The Maternal-Fetal Medicine Units High-Risk Aspirin trial did not show a reduction in either preeclampsia or small-for-gestational-age birth in diabetic women. OBJECTIVE: Our objective was to reassess the impact of aspirin on fetal growth in diabetic pregnancies overall and according to White classification...
June 30, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28576307/serological-evolution-in-women-with-positive-antiphospholipid-antibodies
#11
Leyre Riancho-Zarrabeitia, Germán Daroca, Pedro Muñoz, Marcos López-Hoyos, Ana Haya, Víctor M Martínez-Taboada
OBJECTIVES: To explore the clinical and serological course of fertile women with positive antiphospholipid (aPL), and the factors and therapeutic implications associated with aPL negativization. METHODS: Retrospective study including 105 women with a positive aPL serology between 1995 and 2013 attending the obstetric autoimmune pathology clinic of a tertiary facility. Patients were classified into the following 3 groups: patients with primary antiphospholipid syndrome (pAPS, 49), patients with a positive serology for aPL, not meeting clinical criteria (42), and patients with systemic lupus erythematosus and a positive aPL serology (14)...
May 10, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/28553146/recurrent-pregnancy-loss-current-perspectives
#12
REVIEW
Hady El Hachem, Vincent Crepaux, Pascale May-Panloup, Philippe Descamps, Guillaume Legendre, Pierre-Emmanuel Bouet
Recurrent pregnancy loss is an important reproductive health issue, affecting 2%-5% of couples. Common established causes include uterine anomalies, antiphospholipid syndrome, hormonal and metabolic disorders, and cytogenetic abnormalities. Other etiologies have been proposed but are still considered controversial, such as chronic endometritis, inherited thrombophilias, luteal phase deficiency, and high sperm DNA fragmentation levels. Over the years, evidence-based treatments such as surgical correction of uterine anomalies or aspirin and heparin for antiphospholipid syndrome have improved the outcomes for couples with recurrent pregnancy loss...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28499532/updates-on-the-recognition-prevention-and-management-of-hypertension-in-pregnancy
#13
REVIEW
Jessica R Jackson, Anthony R Gregg
Systematic reviews with meta-analysis represent the highest level of evidence used to guide clinical practice. The defining criteria used to diagnose preeclampsia have evolved, and will likely continue to evolve. Proteinuria is sufficient but not necessary when defining preeclampsia. Hypertension without proteinuria but with severe features is diagnostic. The methods used to measure urinary protein have changed. The gold standard remains the 24-hour urine test. The efficacy of low-dose aspirin in preventing preeclampsia is a function of baseline risk...
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28479751/uterine-cd56-dim-and-cd16-cells-in-refractory-antiphospholipid-antibody-related-pregnancy-loss-and-chromosomally-intact-abortuses-a-case-control-study
#14
Mostafa F Gomaa, Abdeiiatif G Elkhouly, Mohammad M Farghly, Laila A Farid, Nahla M Awad
AIM: To evaluate the role of uterine natural killer (uNK) CD56(dim) and CD16(+) cells in patients with refractory antiphospholipid, antibody-mediated, recurrent, pregnancy loss. SETTINGS AND DESIGN: A case-control study was conducted between 2012 and 2015 at a university hospital. PATIENTS AND METHODS: A group of 118 women with a history of antiphospholipid antibody syndrome experiencing fetal loss in spite of low dose aspirin (LDA) and low molecular weight heparin (LMWH) treatment in the current pregnancy were included in this study...
January 2017: Journal of Human Reproductive Sciences
https://www.readbyqxmd.com/read/28473677/antithrombotic-effects-of-hydroxychloroquine-in-a-pregnant-patient-with-antiphospholipid-syndrome-and-recurrent-venous-thromboembolism
#15
S P Gan, S G Ong
A pregnant woman with antiphospholipid syndrome presented with repeated venous thromboembolism (VTE) in the first and second trimesters of pregnancy despite receiving combination therapy with low-molecular-weight heparin and aspirin. The addition of hydroxychloroquine prevented further VTE recurrence, thus demonstrating its potential antithrombotic effects.
April 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28468653/a-description-of-the-methods-of-the-aspirin-supplementation-for-pregnancy-indicated-risk-reduction-in-nulliparas-aspirin-study
#16
Matthew K Hoffman, Shivaprasad S Goudar, Bhalachandra S Kodkany, Norman Goco, Marion Koso-Thomas, Menachem Miodovnik, Elizabeth M McClure, Dennis D Wallace, Jennifer J Hemingway-Foday, Antoinette Tshefu, Adrien Lokangaka, Carl L Bose, Elwyn Chomba, Musaku Mwenechanya, Waldemar A Carlo, Ana Garces, Nancy F Krebs, K Michael Hambidge, Sarah Saleem, Robert L Goldenberg, Archana Patel, Patricia L Hibberd, Fabian Esamai, Edward A Liechty, Robert Silver, Richard J Derman
BACKGROUND: Preterm birth (PTB) remains the leading cause of neonatal mortality and long term disability throughout the world. Though complex in its origins, a growing body of evidence suggests that first trimester administration of low dose aspirin (LDA) may substantially reduce the rate of PTB. METHODS: Hypothesis: LDA initiated in the first trimester reduces the risk of preterm birth. Study Design Type: Prospective randomized, placebo-controlled, double-blinded multi-national clinical trial conducted in seven low and middle income countries...
May 3, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28456434/recurrent-massive-perivillous-fibrin-deposition-and-chronic-intervillositis-treated-with-heparin-and-intravenous-immunoglobulin-a-case-report
#17
Sahar Abdulghani, Felipe Moretti, Andree Gruslin, David Grynspan
BACKGROUND: Massive perivillous fibrin deposition (MPVFD) and chronic intervillositis (CI) are related rare pathological correlates of severe intrauterine growth restriction (IUGR) and fetal loss with high recurrence rates. No standard management has been established. CASE: A patient underwent termination of pregnancy at 21 weeks for severe early onset IUGR. Placental histology showed mixed CI with MPVFD. Several months later, the patient became pregnant and was managed with prednisone and aspirin (ASA) but miscarried at 16 weeks...
April 26, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28412461/effects-of-low-dose-aspirin-on-maternal-blood-pressure-and-vascular-function-in-an-experimental-model-of-gestational-hypertension
#18
Oluwatobiloba Osikoya, Paresh A Jaini, An Nguyen, Melissa Valdes, Styliani Goulopoulou
Daily intake of low-dose aspirin after 12weeks of gestation is currently recommended as a preventative intervention in pregnancies in high risk of developing preeclampsia. This recommendation is based on epidemiological evidence, whereas experimental studies investigating the exact mechanisms of aspirin action during pregnancy are lacking. We previously showed that treating pregnant rats with a synthetic mimetic of unmethylated CpG DNA (bacterial DNA) caused preeclampsia-like characteristics such as maternal hypertension and increased cyclooxygenase (COX) expression and activity...
June 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28367651/outcomes-in-an-obstetrical-population-with-hereditary-thrombophilia-and-high-tobacco-use
#19
Byron Calhoun, Elizabeth Hoover, Dara Seybold, Mike Broce, Ashley Hill, Burk Shaible, Luis A Bracero
OBJECTIVE: The purpose of this study was to examine birth outcomes in women treated or untreated for thrombophilia during pregnancies affected or not by tobacco exposure. METHODS: This was a retrospective cohort study of consecutive women from a single maternal fetal medicine clinic who delivered between January 2009 and December 2013. We compared birth outcomes by four groups of thrombophilia and smoking combinations and then by treated or untreated groups. RESULTS: Of the 8889 pregnant women in this study, 113 had thrombophilia and 97 received treatment...
April 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28360907/aspirin-the-mechanism-of-action-revisited-in-the-context-of-pregnancy-complications
#20
REVIEW
Angela P Cadavid
Aspirin is one of the most frequently used and cheapest drugs in medicine. It belongs to the non-steroidal anti-inflammatory drugs with a wide range of pharmacological activities, including analgesic, antipyretic, and antiplatelet properties. Currently, it is accepted to prescribe a low dose of aspirin to pregnant women who are at high risk of preeclampsia (PE) because it reduces the onset of this complication. Another pregnancy alteration in which a low dose of aspirin is recommended is the obstetric antiphospholipid syndrome (APS)...
2017: Frontiers in Immunology
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