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Aspirin with preeclampsia

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https://www.readbyqxmd.com/read/29913174/low-dose-aspirin-is-associated-with-reduced-spontaneous-preterm-birth-in-nulliparous-women
#1
Maria Andrikopoulou, Stephanie E Purisch, Roxane Handal-Orefice, Cynthia Gyamfi-Bannerman
BACKGROUND: Preterm birth (PTB) is one of the leading causes of perinatal morbidity and mortality. Clinical data suggests that low dose aspirin may decrease the rate of overall PTB, but investigators have speculated that this is likely due to a decrease in medically indicated PTB through its effect on the incidence of preeclampsia and other placental disease. We hypothesized that low dose aspirin may also impact the mechanism of spontaneous preterm labor. OBJECTIVE: Our objective was to determine whether low dose aspirin reduces the rate of spontaneous PTB in nulliparous women without medical co-morbidities...
June 15, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29852233/the-first-trimester-of-pregnancy-a-window-of-opportunity-for-prediction-and-prevention-of-pregnancy-complications-and-future-life
#2
REVIEW
Liona C Poon, H David McIntyre, Jonathan A Hyett, Eduardo Borges da Fonseca, Moshe Hod
The International Federation of Gynecology and Obstetrics (FIGO) has identified non communicable maternal diseases (NCDs) as a new focus area. NCDs and exposures as related to pregnancy complications and later impairment of maternal and offspring health will form the basis for action in the forthcoming years. This paper summarizes recent advances, centered on the use of first-trimester testing, as a window of opportunity to predict and prevent many pregnancy complications; and for potential future prevention of NCDs in mother and offspring...
May 28, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29802215/aspirin-effect-on-adverse-pregnancy-outcomes-associated-with-stage-1-hypertension-in-a-high-risk-cohort
#3
Alisse Hauspurg, Elizabeth F Sutton, Janet M Catov, Steve N Caritis
Recently, the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines revised the recommendations for diagnosis of chronic hypertension. The new classification system includes a diagnosis of stage 1 hypertension in adults with blood pressures 130 to 139/80 to 89 mm Hg. We sought to compare outcomes among women at high risk for preeclampsia with stage 1 hypertension and assessed whether women with stage 1 hypertension had benefit from aspirin treatment compared with high-risk normotensive women...
May 25, 2018: Hypertension
https://www.readbyqxmd.com/read/29786509/-targeted-screening-for-pre-eclampsia-in-the-first-trimester-of-pregnancy-at-toulouse-university-hospital
#4
A Genoux, P Guerby, M Morin, B Perret, C Vayssière, S M Hamdi
GOALS: Preeclampsia (PE) is a leading cause of maternal and neonatal morbidity and mortality. Early treatment by aspirin has been shown to significantly reduce PE risk before 37weeks supporting the implementation of first-trimester screening. SUBJECTS AND METHODS: A targeted screening was recently implemented at Toulouse University Hospital for women in their first pregnancy or those with personal or familial history of PE. It uses Fetal Medicine Foundation (FMF) algorithm that combines maternal characteristics, clinical, biophysical and biochemical (PAPP-A, Pregnancy Associated Plasma Protein-A, and PlGF, Placental Growth Factor) data...
May 18, 2018: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29781078/prediction-of-preeclampsia-developing-at-term
#5
Iulia Huluta, Anca Maria Panaitescu
Preterm preeclampsia (PE), occurring at < 37 weeks' gestation, can be predicted from as early as 11-13 weeks and prevented with the use of aspirin. In contrast, term PE, which is more common than preterm-PE and it can be associated with important maternal morbidity and mortality, cannot be effectively predicted at 11-13 weeks and cannot be prevented by the prophy-lactic use of aspirin. This paper briefly reviews the pathogenesis of term PE and discusses strategies available for its prediction.
2018: Ginekologia Polska
https://www.readbyqxmd.com/read/29739273/angiogenic-dysregulation-in-pregnancy-related-hypertension-a-role-for-metformin
#6
Nerolen Soobryan, Saravanakumar Murugesan, Arunagiri Pandiyan, Jagidesa Moodley, Irene Mackraj
In the face of escalating maternal and fetal health threats, hypertensive pregnancy disorders (HPDs) is one of the leading cause of maternal and fetal morbidity and mortality. The range of HPDs include white-coat hypertension, chronic hypertension, gestational hypertension, mild-to-moderate and severe preeclampsia and eclampsia. Current evidence implicates an imbalance of circulating anti- and angiogenic factors in HPDs emanating from the placental vasculature, impacting on angiogenesis. Delivery of the fetus is thus far the only curative measure, albeit with increased risk...
January 1, 2018: Reproductive Sciences
https://www.readbyqxmd.com/read/29725376/low-dose-aspirin-at-%C3%A2-16-weeks-of-gestation-for-preventing-preeclampsia-and-its-maternal-and-neonatal-adverse-outcomes-a-systematic-review-and-meta-analysis
#7
Yuechong Cui, Bin Zhu, Fei Zheng
The aim of the present meta-analysis study was to evaluate the efficacy of low-dose aspirin, commenced at ≤16 weeks of gestation, in preventing preterm and term preeclampsia, as well as associated maternal and neonatal adverse events in women at risk of preeclampsia. The Embase, PubMed, Cochrane Central Register of Controlled Trials and the Web of Science databases were searched for relevant random controlled trials (RCTs) published between January 1979 and October 2017. After quality assessment and data extraction, a meta-analysis was performed using RevMan 5...
May 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29718107/the-intervention-effect-of-aspirin-on-a-lipopolysaccharide-induced-preeclampsia-like-mouse-model-by-inhibiting-the-nf-%C3%AE%C2%BAb-pathway
#8
Guanlin Li, Liyang Ma, Li Lin, Yan-Ling Wang, Huixia Yang
Preeclampsia is a severe pregnancy-related disorder, and patients usually present with high circulating inflammatory factor production as well as excessive activation of the nuclear factor-κB (NF-κB) pathway. Administration of aspirin (ASP) is effective for the prevention of preeclampsia, we proposed that ASP might affect placental function by regulating the NF-κB pathway. Systemic lipopolysaccharide (LPS) (20 μg/kg) was used to induce preeclampsia-like pregnant mouse model and low-dose ASP (15.2 mg/kg) were further treated...
April 27, 2018: Biology of Reproduction
https://www.readbyqxmd.com/read/29704277/prediction-and-prevention-of-small-for-gestational-age-neonates-evidence-from-spree-and-aspre
#9
M Y Tan, L C Poon, D L Rolnik, A Syngelaki, C de Paco Matallana, R Akolekar, S Cicero, D Janga, M Singh, F S Molina, N Persico, J C Jani, W Plasencia, E Greco, G Papaioannou, D Wright, K H Nicolaides
OBJECTIVES: To examine the effect of first-trimester screening for pre-eclampsia (PE) on the prediction of delivering a small-for-gestational-age (SGA) neonate and the effect of prophylactic use of aspirin on the prevention of SGA. METHODS: The data for this study were derived from two multicenter studies. In SPREE, we investigated the performance of screening for PE by a combination of maternal characteristics and biomarkers at 11-13 weeks' gestation. In ASPRE, women with a singleton pregnancy identified by combined screening as being at high risk for preterm PE (> 1 in 100) participated in a trial of aspirin (150 mg/day from 11-14 until 36 weeks' gestation) compared to placebo...
April 28, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29683306/maternity-care-update-prenatal-care-and-specific-conditions
#10
Andrew Smith, Wendy B Barr, Erin Bassett-Novoa, Nicholas LeFevre
Early initiation of prenatal care is associated with improved health outcomes for women and newborns. An essential element of prenatal care is determining the estimated due date, ideally using a first-trimester ultrasound. Laboratory tests should be obtained to screen for conditions that can affect pregnancy. Routine immunizations for all pregnant women include influenza vaccine; tetanus toxoid, reduced diphtheria, acellular pertussis (Tdap) vaccine. All women should be screened for gestational diabetes mellitus in midpregnancy...
April 2018: FP Essentials
https://www.readbyqxmd.com/read/29505771/aspirin-for-evidence-based-preeclampsia-prevention-trial-effect-of-aspirin-on-length-of-stay-in-the-neonatal-intensive-care-unit
#11
David Wright, Daniel L Rolnik, Argyro Syngelaki, Catalina de Paco Matallana, Mirian Machuca, Mercedes de Alvarado, Sofia Mastrodima, Min Yi Tan, Siobhan Shearing, Nicola Persico, Jacques C Jani, Walter Plasencia, George Papaioannou, Francisca S Molina, Liona C Poon, Kypros H Nicolaides
BACKGROUND: Preeclampsia is a major pregnancy complication with adverse short- and long-term implications for both the mother and baby. Screening for preeclampsia at 11-13 weeks' gestation by a combination of maternal demographic characteristics and medical history with measurements of biomarkers can identify about 75% of women who develop preterm preeclampsia with delivery at <37 weeks' gestation and 90% of those with early preeclampsia at <32 weeks, at a screen-positive rate of 10%...
June 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29465714/preeclampsia-induced-by-stox1-overexpression-in-mice-induces-intrauterine-growth-restriction-abnormal-ultrasonography-and-bold-mri-signatures
#12
Hélène Collinot, Carmen Marchiol, Isabelle Lagoutte, Franck Lager, Nathalie Siauve, Gwennhael Autret, Daniel Balvay, Gilles Renault, Laurent J Salomon, Daniel Vaiman
BACKGROUND: Preeclampsia is a major hypertensive disease caused by pregnancy, inducing proteinuria and increased blood pressure starting from the second half of pregnancy (early preeclampsia) or near the end of pregnancy (late preeclampsia). Pre-symptomatic diagnosis would allow for therapeutic interventions, such as with low-dose aspirin. Among non-invasive methods to explore organ physiology, Doppler ultrasonography (US) and functional blood oxygenation level-dependent (BOLD) MRI (which do not need radioactive contrast agents such as gadolinium) can be used in pregnant women...
June 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29442407/prediction-and-prevention-of-pre-eclampsia-in-asian-subpopulation
#13
REVIEW
Tuangsit Wataganara, Jarunee Leetheeragul, Suchittra Pongprasobchai, Anuwat Sutantawibul, Chayawat Phatihattakorn, Surasak Angsuwathana
The benefit of the early administration of aspirin to reduce preterm pre-eclampsia among screened positive European women from multivariate algorithmic approach (ASPRE trial) has opened an intense debate on the feasibility of universal screening. This review aims to assess the new perspectives in the combined screening of pre-eclampsia in the first trimester of pregnancy and the chances for prevention using low-dose aspirin with special emphasis on the particularities of the Asian population. PubMed, CENTRAL and Embase databases were searched from inception until 15 November 2017 using combinations of the search terms: preeclampsia, Asian, prenatal screening, early prediction, ultrasonography, pregnancy, biomarker, mean arterial pressure, soluble fms-like tyrosine kinase-1, placental growth factor, pregnancy-associated plasma protein-A and pulsatility index...
February 14, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29439623/aspirin-ameliorates-preeclampsia-induced-by-a-peroxisome-proliferator-activated-receptor-antagonist
#14
Chunhua Zhang, Yong Zhu, Yan Shen, Changting Zuo
Reduced expression of peroxisome proliferator-activated receptor γ (PPARγ) in the placenta was found in women with severe preeclampsia. Aspirin is currently used as the only recommended intervention in pregnancies for prevention of preeclampsia. In this study, we aimed to investigate whether aspirin could attenuate PPARγ inhibitor (T0070907)-induced preeclampsia and its impact on expression of PPARγ. Sixty Sprague-Dawley rats were used and treated with different doses of aspirin (0, 1, and 1.5 mg/kg) in presence or absence of PPARγ antagonist, T0070907...
January 1, 2018: Reproductive Sciences
https://www.readbyqxmd.com/read/29381473/low-dose-aspirin-for-preventing-fetal-growth-restriction-a-randomised-trial
#15
Anca-Daniela Stanescu, Roxana Banica, Romina-Marina Sima, Liana Ples
The purpose of this study was to investigate when in pregnancy to stop the administration of low dose aspirin (150 mg/daily) so as to prevent fetal growth restriction (FGR) A randomised, placebo-controlled study was designed. The patients were all screened positive using the Fetal Medicine Foundation (FMF) early pregnancy screening test for preeclampsia (PE) and FGR prediction. One hundred and fifty patients were enrolled and divided equally into three groups: A - the controls who received placebo treatment; B - those who received aspirin till 32 weeks of gestation and C - those who received aspirin till 36 weeks of gestation...
January 30, 2018: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29366353/effect-of-early-use-of-low-dose-aspirin-therapy-on-late-onset-preeclampsia
#16
Patrick G Lan, Adrian G Gillin, Marilena Pelosi, Jane Tooher, Puk Sandager, Jon Hyett
OBJECTIVE: Low-dose aspirin (LDA) therapy has been found to be effective in preventing the development of early-onset preeclampsia. However, its effect on late-onset preeclampsia has not been described. Our study was aimed at determining if LDA therapy prescribed from early in pregnancy modified the severity of late-onset preeclampsia. MATERIALS AND METHODS: A retrospective analysis of all women who were screened for early-onset preeclampsia at 11-13+6 weeks' gestation between April 2012 and October 2014 at our institution, and who subsequently developed late-onset preeclampsia...
January 24, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29305829/meta-analysis-on-the-effect-of-aspirin-use-for-prevention-of-preeclampsia-on-placental-abruption-and-antepartum-hemorrhage
#17
REVIEW
Stephanie Roberge, Emmanuel Bujold, Kypros H Nicolaides
OBJECTIVE DATA: Impaired placentation in the first 16 weeks of pregnancy is associated with increased risk of subsequent development of preeclampsia, birth of small-for-gestational-age neonates, and placental abruption. Previous studies reported that prophylactic use of aspirin reduces the risk of preeclampsia and small-for-gestational-age neonates with no significant effect on placental abruption. However, meta-analyses of randomized controlled trials that examined the effect of aspirin in relation to gestational age at onset of therapy and dosage of the drug reported that significant reduction in the risk of preeclampsia and small-for-gestational-age neonates is achieved only if the onset of treatment is at ≤16 weeks of gestation and the daily dosage of the drug is ≥100 mg...
May 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29274935/does-low-papp-a-predict-adverse-placenta-mediated-outcomes-in-a-low-risk-nulliparous-population-the-great-obstetrical-syndromes-gos-study
#18
Amélie Boutin, Cédric Gasse, Suzanne Demers, Geneviève Blanchet, Yves Giguère, Emmanuel Bujold
OBJECTIVE: First-trimester low concentration of pregnancy-associated plasma protein A (PAPP-A) has been associated with adverse perinatal outcomes in high-risk populations. This study aimed to estimate the ability of PAPP-A to identify adverse outcomes in a low-risk population. METHODS: The study investigators recruited nulliparous women with singleton pregnancy at their 11-13-week ultrasound scan. Serum samples were collected, and maternal PAPP-A concentration was measured using the B ⋅ R ⋅ A ⋅ H ⋅ M ⋅ S PAPP-A KRYPTOR (ThermoFisher Scientific, Hennigsdorf, Germany) automated assay...
December 21, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29229321/the-role-of-aspirin-heparin-and-other-interventions-in-the-prevention-and-treatment-of-fetal-growth-restriction
#19
REVIEW
Katie M Groom, Anna L David
Fetal growth restriction and related placental pathologies such as preeclampsia, stillbirth, and placental abruption are believed to arise in early pregnancy when inadequate remodeling of the maternal spiral arteries leads to persistent high-resistance and low-flow uteroplacental circulation. The consequent placental ischaemia, reperfusion injury, and oxidative stress are associated with an imbalance in angiogenic/antiangiogenic factors. Many interventions have centered on the prevention and/or treatment of preeclampsia with results pertaining to fetal growth restriction and small-for-gestational-age pregnancy often included as secondary outcomes because of the common pathophysiology...
February 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29215518/angiogenic-factor-profiles-in-pregnant-women-with-a-history-of-early-onset-severe-preeclampsia-receiving-low-molecular-weight-heparin-prophylaxis
#20
RANDOMIZED CONTROLLED TRIAL
Edouard Lecarpentier, Jean Christophe Gris, Eva Cochery-Nouvellon, Erick Mercier, Cyril Touboul, Ravi Thadhani, S Ananth Karumanchi, Bassam Haddad
OBJECTIVE: To evaluate whether daily low-molecular-weight (LMW) heparin prophylaxis during pregnancy alters profile of circulating angiogenic factors that have been linked with the pathogenesis of preeclampsia and fetal growth restriction. METHODS: This is a planned ancillary study of the Heparin-Preeclampsia trial, a randomized trial in pregnant women with a history of severe early-onset preeclampsia (less than 34 weeks of gestation). In the parent study, all women were treated with aspirin and then randomized to receive LMW heparin or aspirin alone...
January 2018: Obstetrics and Gynecology
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