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[Important Considerations of Low-Dose Aspirin in the Prevention of Preeclampsia].[小剂量阿司匹林预防子痫前期的重要考量]
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本文引用的文献

1
Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia.阿司匹林与安慰剂用于有早产先兆子痫高危风险的妊娠。
N Engl J Med. 2017 Aug 17;377(7):613-622. doi: 10.1056/NEJMoa1704559. Epub 2017 Jun 28.
2
The role of aspirin dose on the prevention of preeclampsia and fetal growth restriction: systematic review and meta-analysis.阿司匹林剂量在预防子痫前期和胎儿生长受限中的作用:系统评价与荟萃分析
Am J Obstet Gynecol. 2017 Feb;216(2):110-120.e6. doi: 10.1016/j.ajog.2016.09.076. Epub 2016 Sep 15.
3
Competing risks model in screening for preeclampsia by maternal factors and biomarkers at 11-13 weeks gestation.孕11至13周时通过母体因素和生物标志物筛查子痫前期的竞争风险模型
Am J Obstet Gynecol. 2016 Jan;214(1):103.e1-103.e12. doi: 10.1016/j.ajog.2015.08.034. Epub 2015 Aug 19.
4
Uterine artery pulsatility index assessment at 11-13 weeks' gestation.孕11至13周时子宫动脉搏动指数评估
Fetal Diagn Ther. 2014;36(4):299-304. doi: 10.1159/000361021. Epub 2014 Aug 1.
5
Combined screening for preeclampsia and small for gestational age at 11-13 weeks.11-13 孕周联合筛查子痫前期和胎儿生长受限
Fetal Diagn Ther. 2013;33(1):16-27. doi: 10.1159/000341712. Epub 2012 Sep 13.
6
A competing risks model in early screening for preeclampsia.一种用于子痫前期早期筛查的竞争风险模型。
Fetal Diagn Ther. 2012;32(3):171-8. doi: 10.1159/000338470. Epub 2012 Jul 27.
7
Early administration of low-dose aspirin for the prevention of preterm and term preeclampsia: a systematic review and meta-analysis.早孕期小剂量阿司匹林用于预防早产和足月前子痫前期:系统评价和荟萃分析。
Fetal Diagn Ther. 2012;31(3):141-6. doi: 10.1159/000336662. Epub 2012 Mar 21.
8
Evaluation of 7 serum biomarkers and uterine artery Doppler ultrasound for first-trimester prediction of preeclampsia: a systematic review.评估 7 种血清生物标志物和子宫动脉多普勒超声在子痫前期的早期预测:系统评价。
Obstet Gynecol Surv. 2011 Apr;66(4):225-39. doi: 10.1097/OGX.0b013e3182227027.
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Is testing for aspirin response worthwhile in high-risk pregnancy?高危妊娠中检测阿司匹林反应是否有价值?
Eur J Obstet Gynecol Reprod Biol. 2011 Jul;157(1):38-42. doi: 10.1016/j.ejogrb.2011.02.026. Epub 2011 Mar 25.
10
Prediction of early, intermediate and late pre-eclampsia from maternal factors, biophysical and biochemical markers at 11-13 weeks.从 11-13 周的母体因素、生物物理和生化标志物预测早发型、中间型和晚发型子痫前期。
Prenat Diagn. 2011 Jan;31(1):66-74. doi: 10.1002/pd.2660.

先兆子痫高危患者妊娠11至14周开始使用150毫克与75毫克阿司匹林的母胎结局比较的初步干预研究:一项随机对照试验

Pilot Interventional Study Comparing Fetomaternal Outcomes of 150 mg Versus 75 mg Aspirin Starting Between 11 and 14 Weeks of Pregnancy in Patients with High Risk of Preeclampsia: A Randomized Control Trial.

作者信息

Kumar Namrata, Das Vinita, Agarwal Anjoo, Pandey Amita, Agrawal Smriti, Singh Amrita

机构信息

1Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow, India.

Lucknow, India.

出版信息

J Obstet Gynaecol India. 2020 Feb;70(1):23-29. doi: 10.1007/s13224-019-01277-5. Epub 2019 Sep 20.

DOI:10.1007/s13224-019-01277-5
PMID:32030002
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6982625/
Abstract

INTRODUCTION

Hypertensive disorders of pregnancies complicate around 5-10% of pregnancies worldwide, and together they are a member of the deadly triad along with haemorrhage and infection that contribute to a significant amount of maternal morbidity and mortality.

AIMS AND OBJECTIVES

To compare differences in the fetomaternal outcomes with the use of 150 mg aspirin versus 75 mg aspirin in pregnant women found to be at high risk of PE.

METHODOLOGY

This was a two-armed double-blind parallel randomized control trial conducted in the Department of Obstetrics and Gynaecology, King George's Medical University, carried over a period of 1 year.

RESULTS

Preeclampsia occurred in 15 of 87 participants (17%) in the 75 mg aspirin group compared with 6 of 91 (6.5%) in the 150 mg aspirin group. There were a significantly higher incidence of PE, its severity and lesser period of gestation at delivery in the group given 75 mg dose compared to the group given 150 mg dose. There were significantly higher values of mean arterial pressure and uterine artery PI in women who developed preeclampsia compared to those who do not in both the groups. Foetal outcomes were observed in both the groups of women, and there was no statistically significant difference between them.

CONCLUSION

This randomized trial showed that among women with singleton pregnancies who were identified by means of first-trimester screening as being at high risk of preterm preeclampsia, use of aspirin 150 mg per day started between 11 and 14 weeks till 36 weeks is a potent intervention to reduce the development of both early- and late-onset preeclampsia as compared to a dose of 75 mg per day.

摘要

引言

妊娠期高血压疾病使全球约5%-10%的妊娠复杂化,并且它们与出血和感染共同构成致命三联征,导致大量孕产妇发病和死亡。

目的

比较在被发现有子痫前期高风险的孕妇中使用150毫克阿司匹林与75毫克阿司匹林时母婴结局的差异。

方法

这是一项双臂双盲平行随机对照试验,在乔治国王医科大学妇产科进行,为期1年。

结果

75毫克阿司匹林组87名参与者中有15名(17%)发生子痫前期,而150毫克阿司匹林组91名中有6名(6.5%)发生子痫前期。与150毫克剂量组相比,75毫克剂量组子痫前期的发生率、严重程度显著更高,分娩时的孕周更短。与未发生子痫前期的女性相比,两组中发生子痫前期的女性平均动脉压和子宫动脉搏动指数的值显著更高。两组女性均观察到胎儿结局,且两组之间无统计学显著差异。

结论

这项随机试验表明,在通过孕早期筛查被确定有早产子痫前期高风险的单胎妊娠女性中,与每天75毫克的剂量相比,在11至14周开始至36周每天使用150毫克阿司匹林是一种有效的干预措施,可减少早发型和晚发型子痫前期的发生。