Uzan S, Merviel P, Beaufils M, Bréart G, Salat-Baroux J
Service de Gynécologie-Obstétrique, Hôpital Tenon, Paris.
Presse Med. 1996;25(1):31-6.
Aspirin, an inhibitor of cyclo-oxygenase, is prescribed in a number of conditions related to abnormal production of prostaglandins including gravidic hypertension. Results of the most recent trials demonstrate that in patients with a past history of pre-eclampsia or intra-uterine growth retardation, a pathological Doppler examination of the uterus, a pathological angiotensin test or an antiphospholipid syndrome, prescription of aspirin at the dose of 100 mg/day can prevent recurrence or development of pre-eclampsia or intra-uterine growth retardation. Treatment should begin as soon as possible during pregnancy, certainly before development of clinical manifestations. After history taking and identification of possible contraindications, bleeding time (Ivy method) is recorded before and after prescription and should be lower than 8 minutes. In case bleeding time exceeds 10 minutes 10 to 15 days after initiating aspirin, doses may be reduced to 50 mg per day or even 50 mg every two or three days to reach the target level. Treatment should generally be continued up to 36 weeks gestation.
阿司匹林作为环氧化酶的抑制剂,常用于多种与前列腺素异常生成相关的病症,包括妊娠高血压。最新试验结果表明,对于有子痫前期或宫内生长受限病史、子宫病理多普勒检查异常、血管紧张素试验病理结果异常或患有抗磷脂综合征的患者,每日服用100毫克剂量的阿司匹林可预防子痫前期或宫内生长受限的复发或进展。治疗应在孕期尽早开始,当然要在临床表现出现之前。在问诊并确定可能的禁忌证后,用药前后需记录出血时间(艾维法),且该时间应低于8分钟。如果在开始服用阿司匹林10至15天后出血时间超过10分钟,剂量可减至每日50毫克,甚至每两到三天50毫克,以达到目标水平。治疗一般应持续至妊娠36周。