Critical Care Obstetrics and Gynecology

Low Dose Aspirin as a Reliable Preventive Tool of Preeclampsia

Preeclampsia is a disease of significant morbidity and mortality at pregnancy. Therefore, researchers focus on prevention and early detection of this disease in order to maintain adequate health care to both mother and fetus. One of the promising preventive tools is Low Dose Aspirin (LDA). Although both pathogeneses of preeclampsia and role of LDA in it are not completely understood, there is strong evidence with good quality that LDA is considered a good preventive tool for preeclampsia. The beneficial effects of LDA include prevention of early-onset disease, associated maternal complications, and fetal complications. That is why many societies include American College of Obstetricians and Gynecologists (ACOG), United States Preventive Services Task Force (USPSTF), World Health Organization (WHO), American Heart Association, American Stroke Association, and others agreed on recommending its use for high-risk patients. On 2013, ACOG recommended LDA for preventing Preeclampsia and its complications besides delaying the onset of the disease for those patients with a past medical history of the early-onset disease and preventing preterm labor before 34 weeks due to preeclampsia. Later on, the USPSTF confirmed LDA use in this regard but they recommended its use for more expanded indications than that considered by ACOG. USPSTF highly recommended LDA for patients with a history of preeclampsia, especially if complicated, history of Diabetes Mellitus (DM), chronic hypertension, multiple gestation, renal disease or autoimmune disease. Moreover, with moderate evidence-based practice, they recommended LDA for patients who have more than one of the following risk factors: nulliparity, obesity (BMI>30), age>35 years, family history of preeclampsia in mother or sister, social factors like low socioeconomic level or previous adverse outcome of pregnancy.

Author(s):

Abanoub Gabra and Mariam Gabra

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