O5. Low-dose aspirin therapy in pregnant women with chronic hypertension
Post on 29-Nov-2016
O4. Predisposing factors for early- and late-onset pre-clampsiaS. Ornaghi, A. Tyurmorezova, V. Giardini, P. Algeri, P.Ceruti, E. Vertemati, P. Vergani (Department of Obstetricsand Gynecology, San Gerardo Hospital University ofMilano Bicocca, Monza, Italy)
Objectives: Early (34.0 wks) and late (>34.0 wks) onsetpreeclampsia (EOLO PE) are supposed to have different eti-ologies, vascular and inammatory disfunction respectively.The aim of our study is to evaluate general characteristics ofwomen affected by either EO or LO PE, to identify risk factorsfor the two forms of disease.
Study design: Retrospective cohort study of 197 consecu-tive singleton women diagnosed as preeclamptic at 22.441.4 wks, from 1/2005 to 9/2009, evaluating demographic,clinical, and ultrasonographic (US) variables on hospitaladmission, in relation to EO vs LO PE. HELLP syndrome andstillbirth cases, and fetus with congenital anomalies wereexcluded. Obesity was dened as a BMI 30 kg/m2. Firstabnormal uterine arteries (UtA) Doppler, evaluated in wo-men with history of APO (previous PE/IUGR/SGA), was de-ned as mean RI > 0.58 or bilateral Notch within 26.0 wks.IUGR was considered as an US AC < 10th.
Results: 136 women had previous APO. EO PE was identi-ed in 98 cases (49.7%). Results of univariate analysis areshowed in Table 1. Multivariate analysis weighed for GA atdelivery showed age > 35 yrs and UtA Doppler related to
EO PE (Table 2), whereas WG > 12 kg to LO PE (p = 0.04;OR = 4.6, CI (95%) = 2.398.87).
Conclusions: Age > 35 yrs and UtA Doppler appeared riskfactors for EO PE, whereas WG > 12 kg for the late form, sup-porting the hypothesis of a different pathogenesis.
PREDICTION AND PREVENTION OF PREECLAMPSIA
O5. Low-dose aspirin therapy in pregnant women withchronic hypertensionE. Baptista, B. Moita, A. Gomes, N. Bento, M.S.J. Pais,E. Marta, P. Moura (Obstetrics Department, CoimbrasUniversity Hospital, Coimbra, Portugal)
Objectives: To determine if low-dose aspirin prophylactictherapy improves obstetric and perinatal outcome in wo-men with chronic hypertension.
Materials and methods: The clinical records of 179 preg-nant women with chronic hypertension, between Jan/2005and Dec/2009, were analysed retrospectively. From these,65 were submitted to low-dose (100 mg) aspirin therapy(group-A) against 114 without therapy (group-B). Obstetricand perinatal outcome in both groups was analyzed. Themain parameters under analysis were: development ofpre-eclampsia, HELLP syndrome, intra-uterine growthrestriction (IUGR), birthweight and neonatal intensive careunit admission.
Results: Mean maternal age was 32.11 years in group-Aand 30.74 in group-B (p = n.s.). No statistical signicancewas observed in pre-eclampsia development (A: 10,76% vs.B: 15,78%; p = n.s.). One case of HELLP syndrome and onecase of placental abruption were reported in group B. Statis-tically signicant difference in IUGR development was ob-served between both groups (A: 6,15% vs. B: 16,67%;p = 0,032). Mean gestational age at delivery was 37.5 weeksin group-A and 37.2 weeks in group-B (p = n.s.). Caesareansection was performed in 50.77% in group-A and 59.65% ingroup-B (p = n.s.). Mean birth weight was 3086,4g ingroup-A and 2948.0 g in group-B (p = n.s.). Neonatal inten-sive care unit admission rate was 16.92% in group-A and18.42% in group-B (p = n.s.). Placental pathology revealedsigns of utero-placental chronic ischemia in 9.23% (group-A) and 9.65% (group-B) (p = n.s.). No signicant complica-tions associated to aspirin therapy were reported in any ofthese groups.
Conclusions: In this subgroup of high risk women, low-dose aspirin prophylaxis was effective in reducing incidenceof IUGR. The other parameters analysed in this study re-vealed no statistically signicant differences.
Table 1Univariate analysis.
Variables EO(N = 98)
LO(N = 99)
Age > 35 years 47% 22% 0.00Nulliparity 49% 62% 0.09History of APO 52% 48% 0.36Pre-pregnancy BMI (kg/m2) 24.1 5.3 24.5 5.9 0.63Obesity 14% 15% N.S.I abnormal UtA Doppler 90% (64/
IUGR 48% 15% 0.00GDM 4% 11% 0.10End-pregnancy BMI (kg/m2) 28.3 5.0 30.2 5.4 0.02WG > 12 kg 33% 71% 0.005 kg/m2 BMI increase 29% 65% 0.007 kg/m2 BMI increase 14% 23% 0.13Admission-to-delivery
interval < 48 h24% 57% 0.00
GA at delivery (weeks) 30.9 2.9 37.6 1.8 0.00
Table 2Weight estimation regression. EO PE.
Variables p-Value OR CI (95%)
Age > 35 yrs 0.04 3.10 1.60 6.03I abnormal UtA Doppler 0.00 6.50 2.4617.56Current IUGR 0.26
Lectures / Pregnancy Hypertension: An International Journal of Womens Cardiovascular Health 1 (2011) 238272 259