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Aspirin in pregnancy

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https://www.readbyqxmd.com/read/28619690/metformin-the-aspirin-of-the-21-st-century-its-role-in-gestational-diabetes-prevention-of-preeclampsia-and-cancer-and-the-promotion-of-longevity
#1
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 anti-diabetic agent, its role as a therapeutic agent is expanding to include treatment of pre-diabetes, gestational diabetes, polycystic ovarian disease, and more recently, experimental studies, as well as 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, reviews the results of meta-analyses of metformin in gestational diabetes, 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
#2
Katlynn Adkins, Amanda A Allshouse, Torri D Metz, Kent D Heyborne
OBJECTIVE: Current United States Preventative Services Task Force and other guidelines recommend low-dose aspirin for all pregnant women with pre-gestational 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. Our objective was to reassess the impact of aspirin on fetal growth in diabetic pregnancies overall and according to White classification...
June 6, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28576307/serological-evolution-in-women-with-positive-antiphospholipid-antibodies
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28351814/combining-several-interventions-to-reduce-the-incidence-of-ohss-a-prospective-cohort-study
#13
Mohamed Elmahdy, Eman A Abdelsalam, Hassan A Maghraby
OBJECTIVE: To assess the outcome of using low-dose aspirin, dopamine agonist and triggering ovulation by low dose of HCG in combination with GnRH agonist in fixed GnRH antagonist protocol in patients at risk of OHSS. STUDY DESIGN: This prospective cohort study was conducted on 50 infertile women who were at high risk of OHSS. They received low dose aspirin from first day of stimulation, cabergoline 0.5mg daily from the day of HCG for 8days and low dose of HCG (2500 IU) in combination with GnRH agonist for final oocyte maturation in fixed GnRH antagonist protocol...
May 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28342880/-for-a-targeted-use-of-aspirin
#14
H Madar, S Brun, F Coatleven, A Nithart, C Lecoq, M Gleyze, B Merlot, L Sentilhes
The use of low-dose aspirin in pregnancy should remain a highly targeted indication since its long-term safety has not been established and should be restricted to women at high risk of vascular complications. Indications for which the benefit of aspirin has been shown are women with a history of preeclampsia responsible for a premature birth before 34 weeks, those having at least two history of preeclampsia, those with an antiphospholipid syndrome and those with lupus associated with positive antiphospholipid antibodies or renal failure...
April 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/28333301/preconception-maternal-lipoprotein-levels-in-relation-to-fecundability
#15
Sarah J Pugh, Enrique F Schisterman, Richard W Browne, Anne M Lynch, Sunni L Mumford, Neil J Perkins, Robert Silver, Lindsey Sjaarda, Joseph B Stanford, Jean Wactawski-Wende, Brian Wilcox, Katherine L Grantz
STUDY QUESTION: Are maternal preconception lipid levels associated with fecundability? SUMMARY ANSWER: Fecundability was reduced for all abnormal female lipid levels including total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and total triglyceride levels. WHAT IS KNOWN ALREADY: Subfecundity affects 7-15% of the population and lipid disorders are hypothesized to play a role since cholesterol acts as a substrate for the synthesis of steroid hormones...
May 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28323989/preconception-low-dose-aspirin-restores-diminished-pregnancy-and-live-birth-rates-in-women-with-low-grade-inflammation-a-secondary-analysis-of-a-randomized-trial
#16
Lindsey A Sjaarda, Rose G Radin, Robert M Silver, Emily Mitchell, Sunni L Mumford, Brian Wilcox, Noya Galai, Neil J Perkins, Jean Wactawski-Wende, Joseph B Stanford, Enrique F Schisterman
Context: Inflammation is linked to causes of infertility. Low-dose aspirin (LDA) may improve reproductive success in women with chronic, low-grade inflammation. Objective: To investigate the effect of preconception-initiated LDA on pregnancy rate, pregnancy loss, live birth rate, and inflammation during pregnancy. Design: Stratified secondary analysis of a multicenter, block-randomized, double-blind, placebo-controlled trial. Setting: Four US academic medical centers, 2007 to 2012...
May 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28295782/multicenter-screening-for-pre-eclampsia-by-maternal-factors-and-biomarkers-at-11-13-weeks-gestation-comparison-with-nice-guidelines-and-acog-recommendations
#17
N O'Gorman, D Wright, L C Poon, D L Rolnik, A Syngelaki, M de Alvarado, I F Carbone, V Dutemeyer, M Fiolna, A Frick, N Karagiotis, S Mastrodima, C de Paco Matallana, G Papaioannou, A Pazos, W Plasencia, K H Nicolaides
OBJECTIVE: To compare the performance of screening for pre-eclampsia (PE) based on risk factors from medical history, as recommended by NICE and ACOG, with the method proposed by The Fetal Medicine Foundation (FMF), which uses Bayes' theorem to combine the a-priori risk from maternal factors, derived by a multivariable logistic model, with the results of various combinations of biophysical and biochemical measurements. METHODS: This was a prospective multicenter study of screening for PE in 8775 singleton pregnancies at 11-13 weeks' gestation...
June 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28295773/a-study-protocol-for-the-prospective-validation-study-screening-programme-for-pre-eclampsia-spree
#18
Min Yi Tan, Lemonia Koutoulas, David Wright, Kypros H Nicolaides, Liona C Poon
INTRODUCTION: Pre-eclampsia (PE), which affects about 2% of pregnancies, is a major cause of maternal and perinatal morbidity and mortality. Early detection of PE can improve pregnancy outcome by providing timely intervention and closer monitoring. The current guideline from the National Institute for Health and Care Excellence (NICE) recommends that at the booking visit, women identified with one major risk factor or more than one moderate risk factor for PE should be advised to take low-dose aspirin daily from 12 weeks until the birth of the baby...
March 13, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28262233/antiphospholipid-syndrome
#19
REVIEW
Ricard Cervera
The antiphospholipid syndrome (APS) is defined by the development of venous and/or arterial thromboses, often multiple, and pregnancy morbidity (mainly, recurrent fetal losses), in the presence of antiphospholipid antibodies (aPL). Some estimates indicate that the incidence of the APS is around 5 new cases per 100,000 persons per year and the prevalence around 40-50 cases per 100,000 persons. The aPL are positive in approximately 13% of patients with stroke, 11% with myocardial infarction, 9.5% of patients with deep vein thrombosis and 6% of patients with pregnancy morbidity...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28238314/-obstetrical-aps-is-there-a-place-for-additional-treatment-to-aspirin-heparin-combination
#20
A Mekinian, G Kayem, J Cohen, L Carbillon, N Abisror, L Josselin-Mahr, M Bornes, O Fain
Obstetrical APS is defined by thrombosis and/or obstetrical morbidity associated with persistent antiphospholipid antibodies. The aspirin and low molecular weighted heparin combination dramatically improved obstetrical outcome in APS patients. Several factors could be associated with obstetrical prognosis, as previous history of thrombosis, associated SLE, the presence of lupus anticoagulant and triple positivity of antiphospholipid antibodies. Obstetrical APS with isolated recurrent miscarriages is mostly associated with isolated anticardiolipids antibodies and have better obstetrical outcome...
January 2017: Gynecologie, Obstetrique, Fertilite & Senologie
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