Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
11025786 | Medical Hypotheses | 2018 | 22 Pages |
Abstract
Clinical trials and meta-analyses have demonstrated that low-dose aspirin can reduce the risk of preeclampsia and fetal growth restriction in high-risk pregnant women. Current obstetric guidelines recommend that the administration of low-dose aspirin to prevent preeclampsia be initiated after 12â¯weeks' gestation. This starting time was chosen to minimize possible risks of maternal bleeding and fetal anomalies. However, evidence from reproductive medicine, where low-dose aspirin is commonly recommended to use before and in early pregnancy, as well as existing literature, does not support these concerns. On the other hand, defective placentation resulting in a subsequent ischemic placenta is considered as the starting point of preeclampsia. Low-dose aspirin initiated in early pregnancy can balance the levels of thromboxane A2 and prostacyclin and maintain adequate uteroplacental blood flow and, therefore, improve placentation. Thus, an initiation of low-dose aspirin earlier than 12â¯weeks can be considered. Meanwhile, evidence shows that low-dose aspirin can improve maternal vascular endothelial function without increasing the risks of adverse maternal and perinatal outcomes. Therefore, it appears safe to use low-dose aspirin as a prophylactic until delivery.
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Authors
Jing Zhu, Rong Huang, Jinwen Zhang, Weiping Ye, Jun Zhang,