Stoilov Boris, Uchikova Ekaterina, Kirovakov Zlatko, Zaharieva-Dinkova Polina
Obstetrics and Gynaecology, Medical University Plovdiv, Plovdiv, BGR.
Midwifery Care, Faculty of Health Care, Medical University Pleven, Pleven, BGR.
Cureus. 2024 Aug 6;16(8):e66298. doi: 10.7759/cureus.66298. eCollection 2024 Aug.
Introduction Preeclampsia (PE) is a syndrome that affects pregnant women after 20 weeks of gestation and involves numerous organ systems. Screening for PE is essential to prevent complications and guide management. Some existing guidelines for screening have limitations in terms of detection rates and false positives. The aim of this study is to assess the therapeutic value of low-dose acetylsalicylic acid (ASA) for the prevention of PE in high-risk Bulgarian women. Methodology A prospective cohort research was carried out, encompassing women who were recruited from several routine consultations, such as booking, scanning, and regular prenatal visits. We utilized the purposive sampling technique to carefully choose potential participants. The study was conducted by a maternal-fetal medicine center located in Plovdiv, Bulgaria. The data-gathering period spanned from January 2018 to November 2020. At the appointment, the following procedures were conducted: 1) recording history; 2) assessing height, weight, and blood pressure; 3) collecting blood specimens for biochemical markers; and 4) ultrasound examination. Results A total sample size of 1,383 individuals was categorized into two distinct groups: high-risk patients (n = 506) and low-risk patients (n = 877). The mean uterine artery pulsatility index (UtA-PI) and mean arterial pressure (MAP) ratios were all greater in high-risk group women (p < 0.05). The data revealed that a significant number of high-risk women failed to adhere to the prescribed dosage or regular use of ASA as recommended by their doctor. There were only 384 (75.9%) high-risk women who took low-dose ASA regularly. Conclusion The findings emphasize the importance of personalized prenatal care and early risk assessment to improve maternal and fetal outcomes. Therefore, it is crucial to educate pregnant women, considering the benefits and risks of low-dose ASA when appropriately indicated.
引言
子痫前期(PE)是一种在妊娠20周后影响孕妇的综合征,涉及多个器官系统。子痫前期的筛查对于预防并发症和指导治疗至关重要。一些现有的筛查指南在检测率和假阳性方面存在局限性。本研究的目的是评估低剂量乙酰水杨酸(ASA)对预防高危保加利亚女性子痫前期的治疗价值。
方法
进行了一项前瞻性队列研究,纳入了从几次常规会诊(如建档、超声检查和定期产前检查)中招募的女性。我们采用目的抽样技术仔细选择潜在参与者。该研究由位于保加利亚普罗夫迪夫的母婴医学中心进行。数据收集期从2018年1月至2020年11月。在预约时,进行了以下程序:1)记录病史;2)评估身高、体重和血压;3)采集血液标本检测生化标志物;4)超声检查。
结果
总共1383名个体被分为两个不同的组:高危患者(n = 506)和低危患者(n = 877)。高危组女性的平均子宫动脉搏动指数(UtA-PI)和平均动脉压(MAP)比值均更高(p < 0.05)。数据显示,大量高危女性未按照医生建议坚持规定剂量或定期使用ASA。只有384名(75.9%)高危女性定期服用低剂量ASA。
结论
研究结果强调了个性化产前护理和早期风险评估对改善母婴结局的重要性。因此,在适当指征下考虑低剂量ASA的益处和风险时,对孕妇进行教育至关重要。