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Aspirin preeclampsia

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https://www.readbyqxmd.com/read/27906745/should-we-add-pravastatin-to-aspirin-for-preeclampsia-prevention-in-high-risk-women
#1
Caroline C Marrs, Maged M Costantine
Preeclampsia is a multisystem disorder that affects 3% to 5% of pregnant women and remains a significant source of short-term and long-term maternal and neonatal mortality and morbidity. Many professional societies recommend the use of low-dose aspirin to prevent preeclampsia in high-risk women. Owing to the similarities in pathophysiology between preeclampsia and atherosclerotic cardiovascular disease, and the encouraging data from preclinical and pilot clinical studies, pravastatin has been proposed for preventing preeclampsia...
November 30, 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27876004/enoxaparin-for-the-prevention-of-preeclampsia-and-intrauterine-growth-restriction-in-women-with-a-prior-history-an-open-label-randomised-trial-the-eppi-trial-study-protocol
#2
K M Groom, L M McCowan, P R Stone, L C Chamley, C McLintock
BACKGROUND: Preeclampsia and intrauterine fetal growth restriction (IUGR) are two of the most common causes of maternal and perinatal morbidity and mortality. Current methods of predicting those at most risk of these conditions remain relatively poor, and in clinical practice past obstetric history remains the most commonly used tool. Aspirin and, in women at risk of preeclampsia only, calcium have been demonstrated to have a modest effect on risk reduction. Several observational studies and randomised trials suggest that low molecular weight heparin (LMWH) therapy may confer some benefit...
November 22, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27810551/antiplatelet-therapy-before-or-after-16-weeks-gestation-for-preventing-preeclampsia-an-individual-participant-data-meta-analysis
#3
REVIEW
Shireen Meher, Lelia Duley, Kylie Hunter, Lisa Askie
BACKGROUND: The optimum time for commencing antiplatelet therapy for the prevention of preeclampsia and its complications is unclear. Aggregate data meta-analyses suggest that aspirin is more effective if given prior to 16 weeks' gestation, but data are limited because of an inability to place women in the correct gestational age subgroup from relevant trials. OBJECTIVE: The objective of the study was to use the large existing individual participant data set from the Perinatal Antiplatelet Review of International Studies Collaboration to assess whether the treatment effects of antiplatelet agents on preeclampsia and its complications vary based on whether treatment is started before or after 16 weeks' gestation...
November 1, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27807890/impact-of-aspirin-on-trophoblastic-invasion-in-women-with-abnormal-uterine-artery-doppler-at-11%C3%A2-%C3%A2-14-weeks-a-randomized-controlled-study-asap
#4
Elena Scazzocchio, Dani Oros, Daysi Diaz, Juan C Ramirez, Marta Ricart, Eva Meler, Rafael González de Agüero, Eduard Gratacos, Francesc Figueras
BACKGROUND: Defective trophoblastic invasion is a key feature in many of cases of preeclampsia. Uterine artery Doppler is a validated non-invasive surrogate of this trophoblastic invasion. OBJECTIVE: To explore whether low-dose aspirin administered from the first trimester improves trophoblastic invasion, evaluated by uterine Doppler, during the second and third trimesters in women defined as high-risk by abnormal uterine artery Doppler at first trimester. METHODS: This randomized Phase II study had a triple-blind, parallel-arm, controlled design...
November 3, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27741174/enoxaparin-and-aspirin-compared-with-aspirin-alone-to-prevent-placenta-mediated-pregnancy-complications-a-randomized-controlled-trial
#5
Bassam Haddad, Norbert Winer, Yvon Chitrit, Véronique Houfflin-Debarge, Céline Chauleur, Karine Bages, Vassilis Tsatsaris, Alexandra Benachi, Florence Bretelle, Jean-Christophe Gris, Sylvie Bastuji-Garin
OBJECTIVE: To evaluate whether daily enoxaparin, added to low-dose aspirin, started before 14 weeks of gestation reduces placenta-mediated complications in pregnant women with previous severe preeclampsia diagnosed before 34 weeks of gestation. METHODS: In this open-label multicenter randomized trial, we enrolled consenting pregnant women with previous severe preeclampsia diagnosed before 34 weeks of gestation, gestational age at randomization of 7-13 weeks, singleton pregnancy, and no plan for anticoagulation...
November 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27703566/early-prognostic-factors-for-the-progress-of-preeclampsia-our-experience-in-the-period-2010-2011
#6
Mariya Angelova, Ivan Todorov, Emil Kovachev
AIM: To determine the prognostic value of the low Pregnancy-associated plasma protein A (PAPP-A) levels in the early stages of pregnancy (11-13 weeks GA) independently and in combination with a Doppler test of the uterine arteries during the second half of pregnancy (22-23 weeks GA). MATERIAL AND METHODS: The study covered the period 2010-2011 and included 106 pregnant women, aged 35-40, with a single child pregnancy. The research excluded pregnant women with anomalies of the fetus, smokers and women taking prophylactically low doses of aspirin...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/27640943/the-role-of-aspirin-dose-on-the-prevention-of-preeclampsia-and-fetal-growth-restriction-systematic-review-and-meta-analysis
#7
REVIEW
Stéphanie Roberge, Kypros Nicolaides, Suzanne Demers, Jon Hyett, Nils Chaillet, Emmanuel Bujold
BACKGROUND: Preeclampsia and fetal growth restriction are major causes of perinatal death and handicap in survivors. Randomized clinical trials have reported that the risk of preeclampsia, severe preeclampsia, and fetal growth restriction can be reduced by the prophylactic use of aspirin in high-risk women, but the appropriate dose of the drug to achieve this objective is not certain. OBJECTIVE: We sought to estimate the impact of aspirin dosage on the prevention of preeclampsia, severe preeclampsia, and fetal growth restriction...
September 15, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27606778/pregnancy-outcomes-in-women-with-preeclampsia-superimposed-on-chronic-hypertension-with-and-without-severe-features
#8
Hind N Moussa, Mateo G Leon, Ana Marti, Alissar Chediak, Claudia Pedroza, Sean C Blackwell, Baha M Sibai
Objective The American Congress of Obstetricians and Gynecologists (ACOG) task force on hypertension in pregnancy introduced a new definition of superimposed preeclampsia (SIP) adding severe features (SF) as new criteria to define severe disease. They also recommended that those with SIP be delivered ≥ 37 weeks, whereas those with SF be delivered ≤ 34 weeks. Our aim was to investigate the validity of this new definition by comparing adverse pregnancy outcomes in SIP with (SIP-SF) and without SF (SIP)...
September 8, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27534740/prediction-and-prevention-of-hypertensive-disorders-of-pregnancy
#9
Akihide Ohkuchi, Chikako Hirashima, Kayo Takahashi, Hirotada Suzuki, Shigeki Matsubara
The most common classifications of hypertensive disorders of pregnancy consist of chronic hypertension, gestational hypertension, preeclampsia (PE) and superimposed PE. A common final pathophysiology of PE is endothelial dysfunction. The most successful translational research model for explaining the cause-effect relationship in the genesis of PE is the angiogenic/angiostatic balance theory, involving soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PlGF) and soluble endoglin (sEng). In a systematic review of articles on the prediction of early-onset PE using angiogenesis-related factors, we revealed that the prediction of early-onset PE in the first trimester is clinically possible, but the prediction of early-onset PE in the early third trimester might be ideal...
August 18, 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/27514126/-early-detection-of-preeclampsia
#10
N Todorov
UNLABELLED: The preeclampsia is one of the most serious complications in the second half of the pregnancy with a high risk of perinatal maternal and neonatal mortality. The study is aiming to determine which pregnant women have a higher risk of developing preeclampsia with a view to the subsequent antenatal care, on the base of the individual factors. MATERIAL AND METODS: From prospectively followed pacients is collected information by a questionnaire and sonographic examination at 11-13 weeks of gestation/w...
2016: Akusherstvo i Ginekologii︠a︡
https://www.readbyqxmd.com/read/27509650/-antithrombotic-medication-in-pregnant-women-with-previous-intrauterine-growth-restriction
#11
K Neykova, V Dimitrova, R Dimitrov, L Vakrilova
AIM: To analyze pregnancy outcome in patients who were on antithrombotic medication (AM) because of previous pregnancy with fetal intrauterine growth restriction (IUGR). MATERIALS AND METHODS: The studied group (SG) included 21 pregnancies in 15 women with history of previous IUGR. The patients were on low dose aspirin (LDA) and/or low molecular weight heparin (LMWH). Pregnancy outcome was compared to the one in two more groups: 1) primary group (PG) including the previous 15 pregnancies with IUGR of the same women; 2) control group (CG) including 45 pregnancies of women matched for parity with the ones in the SG, with no history of IUGR and without medication...
2016: Akusherstvo i Ginekologii︠a︡
https://www.readbyqxmd.com/read/27454295/pravastatin-improves-pregnancy-outcomes-in-obstetric-antiphospholipid-syndrome-refractory-to-antithrombotic-therapy
#12
Eleftheria Lefkou, Apostolos Mamopoulos, Themistoklis Dagklis, Christos Vosnakis, David Rousso, Guillermina Girardi
BACKGROUND: Administration of conventional antithrombotic treatment (low-dose aspirin plus low-molecular weight heparin [LDA+LMWH]) for obstetric antiphospholipid syndrome (APS) does not prevent life-threatening placenta insufficiency-associated complications such as preeclampsia (PE) and intrauterine growth restriction (IUGR) in 20% of patients. Statins have been linked to improved pregnancy outcomes in mouse models of PE and APS, possibly due to their protective effects on endothelium...
August 1, 2016: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/27454294/pravastatin-to-prevent-obstetrical-complications-in-women-with-antiphospholipid-syndrome
#13
Maged M Costantine
Pregnant women with antiphospholipid syndrome (APS) are at a high risk of obstetrical complications. The current standard of care, including the use of low-dose aspirin and heparin, has not been shown to prevent preeclampsia or intrauterine growth restriction (IUGR). Due to the similarities in pathophysiology among preeclampsia, IUGR, and atherosclerotic cardiovascular disease, statins have been proposed for treating and/or preventing these obstetrical complications. In this issue of the JCI, Lefkou et al. report on a small, observational trial that showed a dramatic improvement in both maternal and fetal/neonatal outcomes in women with APS given pravastatin after the onset of preeclampsia and/or IUGR compared with women in the control group...
August 1, 2016: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/27417614/preeclampsia-eclampsia-adverse-outcomes-reduction-the-preeclampsia-eclampsia-checklist
#14
Oroma B Nwanodi
Globally, preeclampsia-eclampsia (PE-E) is a major cause of puerperal intensive care unit admission, accounting for up to 10% of maternal deaths. PE-E primary prevention is possible. Antepartum low-dose aspirin prophylaxis, costing USD $10-24 can cut the incidence of PE-E in half. Antepartum low molecular weight heparin combined with low-dose aspirin prophylaxis can cut the incidence of early onset PE-E and fetuses that are small for their gestational age in half. Despite predictive antepartum models for PE-E prophylaxis, said prophylaxis is not routinely provided...
2016: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/27354081/study-protocol-for-the-randomised-controlled-trial-combined-multimarker-screening-and-randomised-patient-treatment-with-aspirin-for-evidence-based-preeclampsia-prevention-aspre
#15
Neil O'Gorman, David Wright, Daniel L Rolnik, Kypros H Nicolaides, Liona C Poon
INTRODUCTION: Pre-eclampsia (PE) affects 2-3% of all pregnancies and is a major cause of maternal and perinatal morbidity and mortality. Prophylactic use of low-dose aspirin in women at risk for PE may substantially reduce the prevalence of the disease. Effective screening for PE requiring delivery before 37 weeks (preterm PE) can be provided by a combination of maternal factors, uterine artery Doppler, mean arterial pressure, maternal serum pregnancy-associated plasma protein A and placental growth factor at 11-13 weeks' gestation, with a detection rate of 75% at a false-positive rate of 10%...
June 28, 2016: BMJ Open
https://www.readbyqxmd.com/read/27315190/preventing-preeclampsia-and-its-fetal-complications-with-low-dose-aspirin-in-east-asians-and-non-east-asians-a-systematic-review-and-meta-analysis
#16
Jie Gan, Huan He, Hongbo Qi
BACKGROUND: Low-dose aspirin can reduce the incidence of preeclampsia and intrauterine growth restriction (IUGR). However, the effects of ethnicity upon low-dose aspirin's efficacy has not been analyzed. Here, we comparatively evaluated the efficacy of low-dose aspirin in preventing preeclampsia and related fetal complications in East Asian and non-East Asian pregnant women at risk for preeclampsia. METHODS: Several databases were searched for randomized controlled trials (RCTs) comparing low-dose aspirin with either placebo or no treatment in pregnant women at risk for preeclampsia...
August 2016: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/27258324/in-utero-exposure-to-aspirin-and-risk-of-asthma-in-childhood
#17
Shuyuan Chu, Lisu Huang, Yixiao Bao, Jun Bao, Hongping Yu, Jun Zhang
BACKGROUND: Aspirin is widely used in general population and low-dose aspirin is commonly prescribed to prevent recurrent pregnancy loss associated with antiphospholipid syndrome and preeclampsia, often used throughout pregnancy. But aspirin is associated with asthma pathogenesis. We aim to examine whether in utero exposure to aspirin at different fetal stages is associated with asthma in childhood. METHODS: We used data from the Collaborative Perinatal Project...
September 2016: Epidemiology
https://www.readbyqxmd.com/read/27251704/aspirin-vs-heparin-for-the-prevention-of-preeclampsia
#18
REVIEW
Vasiliki Katsi, Theoni Kanellopoulou, Thomas Makris, Petros Nihoyannopoulos, Efrosyni Nomikou, Dimitrios Tousoulis
Preeclampsia is a hypertensive disorder of pregnancy that remains a significant cause of maternal morbidity and mortality worldwide. Preeclampsia can be resolved by delivery, and most of the proposed preventive treatment approaches are based on processes involved in placental development in early pregnancy. Yet, none of these has been established in clinical practice. Low-dose aspirin is the most promising candidate, nevertheless; while some individual randomized controlled trials showed minimal or no statistically significant benefit, recent metanalyses showed that early initiation before 16 weeks of gestation is associated with prevention of early-onset preeclampsia and reduction in prevalence of perinatal death or morbidity of pregnant women...
July 2016: Current Hypertension Reports
https://www.readbyqxmd.com/read/27235915/aspirin-for-the-prevention-of-preeclampsia-and-intrauterine-growth-restriction
#19
REVIEW
Stephanie Roberge, Anthony O Odibo, Emmanuel Bujold
Low-dose aspirin (LDA) has been used for several years for the prevention of preeclampsia (PE). LDA started in early pregnancy is associated with improvement of placental implantation. The best evidence suggest that LDA can prevent more than half of PE cases in high-risk women when started before 16 weeks of gestation. Moreover, LDA started in early pregnancy reduces the risk of other placenta-mediated complications such as intrauterine growth restriction (IUGR) and perinatal death. The efficacy of LDA has been demonstrated in women with abnormal first-trimester uterine artery Doppler or with prior history of chronic hypertension or preeclampsia...
June 2016: Clinics in Laboratory Medicine
https://www.readbyqxmd.com/read/27209297/prevention-of-hypertensive-disorders-of-pregnancy-a-novel-application-of-the-polypill-concept
#20
J L Browne, K Klipstein-Grobusch, A Franx, D E Grobbee
Nearly all of the annual 287,000 global maternal deaths are preventable. Hypertensive disorders of pregnancy (HDP) are among the major causes. A novel fixed-dose combination pill or polypill to prevent cardiovascular disease is a promising strategy for prevention of HDP. The aim of this study was to identify eligible candidates for a polypill for the prevention of HDP. A comprehensive review of systematic reviews on drug and dietary interventions to prevent HDP was conducted. Interventions were evaluated based on efficacy, dose, route of administration, and side effects...
June 2016: Current Cardiology Reports
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