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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.

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。

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ASPRE trial: performance of screening for preterm pre-eclampsia.ASPRE 试验:早产子痫前期筛查的表现。
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