The early intervention and preventive value of low-dose aspirin in preeclampsia.

doi:10.7504/fk2014090104

Abstract

Abstract:

Abstract: Preeclampsia is a common obstetric disorder with high perinatal mortality and iatrogenic preterm birth. There is extensive evidence from randomized studies that modulating the impaired PGI2/TXA2 ratio in pathogenesis of preeclampsia by prophylactic administration of low-dose aspirin appears to be associated with a reduction in the prevalence of preeclampsia. It is recommended to initiate administration of daily low-dose aspirin beginning in the late first trimester for women at risk to prevent preeclampsia while not inducing maternal and fetal hemorrhage.

Key words: preeclampsia, aspirin, prevention, intervention

摘要：

子痫前期是母儿围产期死亡及医源性早产的重要原因，近年来越来越多研究表明妊娠期应用小剂量阿司匹林可改善子痫前期发病过程中前列环素(PGI2)/ 血栓素A2(TXA2)比例失衡所致的血液高凝状态，从而预防子痫前期的发生。建议有高危因素的孕妇，在妊娠早期结束后尽快开始口服小剂量阿司匹林，在有效预防子痫前期发病的同时并不增加胎儿及产妇的出血风险，从而获得良好的母儿结局。

关键词: 子痫前期, 阿司匹林, 预防, 干预

CLC Number:

R714.24+4

HUANG He，CHEN Qian.. The early intervention and preventive value of low-dose aspirin in preeclampsia.[J]. Acta Metallurgica Sinica, DOI: 10.7504/fk2014090104.

黄禾，陈倩. 小剂量阿司匹林对子痫前期早期干预和预防作用[J]. 中国实用妇科与产科杂志, DOI: 10.7504/fk2014090104.

References

参考文献

［1］   Voelker R. USPSTF: Low-dose aspirin may help reduce risk of preeclampsia［J］. Jama， 2014,311(20):2055.

［2］   Roberge S, Villa P, Nicolaides K, et al. Early administration of low-dose aspirin for the prevention of preterm and term preeclampsia: a systematic review and meta-analysis［J］. Fetal Diagn Therapy， 2012,31(3):141-6.

［3］   Askie LM, Duley L, Henderson-Smart DJ,et al. Antiplatelet agents for prevention of pre-eclampsia: a meta-analysis of individual patient data［J］.Lancet,2007,369(9575):1791-1798.

［4］   Friedman AM, Cleary KL. Prediction and prevention of ischemic placental disease［J］. Semin Perinatol, 2014,38(3):177-182.

［5］   Dekker GA, Sibai BM. Low-dose aspirin in the prevention of preeclampsia and fetal growth retardation: rationale, mechanisms, and clinical trials［J］. Am J Obstet Gynecol, 1993,168(1 Pt 1):214-227.

［6］   Heyborne KD. Preeclampsia prevention: lessons from the low-dose aspirin therapy trials［J］. Am J Obstet Gynecol, 2000,183(3):523-528.

［7］   Ayala DE, Ucieda R, Hermida RC. Chronotherapy with low-dose aspirin for prevention of complications in pregnancy［J］. Chronobiol Int, 2013,30(1-2):260-279.

［8］   Duley L, Henderson-Smart DJ, Meher S,et al. Antiplatelet agents for preventing pre-eclampsia and its complications［J］. Cochrane Database Syst Rev, 2007,18（2）：341-347.

［9］   Rossi AC, Mullin PM. Prevention of pre-eclampsia with low-dose aspirin or vitamins C and E in women at high or low risk: a systematic review with meta-analysis［J］. Eur J Obstet Gynecol Reprod Biol, 2011,158(1):9-16.

［10］   Eiland E, Nzerue C, Faulkner M. Preeclampsia 2012［J］. J Pregn, 2012,2012:586-588.

［11］   Schramm AM, Clowse ME. Aspirin for prevention of preeclampsia in lupus pregnancy［J］. Autoimmune Dis, 2014,2014:920467.

［12］   Redman CWG. Hypertension in pregnancy: the NICE guidelines［J］. Heart, 2011,97(23):1967-1969.

［13］   Henderson JT, Whitlock EP, O'Connor E,et al. Low-dose aspirin for prevention of morbidity and mortality from preeclampsia: a systematic evidence review for the US Preventive Services Task Force［J］. Ann Intern Med, 2014,160(10):695-703.

［14］   Marret S, Marchand L, Kaminski M, et al. Prenatal low-dose aspirin and neurobehavioral outcomes of children born very preterm［J］. Pediatrics, 2010,125(1):e29-e34.

（2014-06-20收稿）

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