Antiplatelet therapy in pregnancy: A systematic review

Nana, Melanie; Morgan, Holly; Moore, Sacha; Lee, Zong Xuan; Ang, Eshen; Nelson‐Piercy, Catherine

doi:10.1016/j.phrs.2021.105547

Cited by 15 publications

(12 citation statements)

References 47 publications

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“…Low-dose aspirin prophylaxis is indicated in patients at a high-risk of developing preeclampsia [ 186 ]. Dual antiplatelet therapy (aspirin and P2Y12 receptor blocker) has been used to manage pregnancy-associated myocardial infarction following a percutaneous coronary intervention (PCI) with intracoronary stenting [ 187 , 188 , 189 ]. Interestingly, aspirin suppressed the cargo levels of proinflammatory cytokines and mediators in platelet-derived exosomes [ 190 ].…”

Section: Placenta-derived Evs As Hb Bart’s Liquid Biopsy: Challenges ...mentioning

confidence: 99%

Placenta-Derived Extracellular Vesicles in Pregnancy Complications and Prospects on a Liquid Biopsy for Hemoglobin Bart’s Disease

Chaemsaithong

Luewan

Taweevisit

et al. 2023

IJMS

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Extracellular vesicles (EVs) are nano-scaled vesicles released from all cell types into extracellular fluids and specifically contain signature molecules of the original cells and tissues, including the placenta. Placenta-derived EVs can be detected in maternal circulation at as early as six weeks of gestation, and their release can be triggered by the oxygen level and glucose concentration. Placental-associated complications such as preeclampsia, fetal growth restriction, and gestational diabetes have alterations in placenta-derived EVs in maternal plasma, and this can be used as a liquid biopsy for the diagnosis, prediction, and monitoring of such pregnancy complications. Alpha-thalassemia major (“homozygous alpha-thalassemia-1”) or hemoglobin Bart’s disease is the most severe form of thalassemia disease, and this condition is lethal for the fetus. Women with Bart’s hydrops fetalis demonstrate signs of placental hypoxia and placentomegaly, thereby placenta-derived EVs provide an opportunity for a non-invasive liquid biopsy of this lethal condition. In this article, we introduced clinical features and current diagnostic markers of Bart’s hydrops fetalis, extensively summarize the characteristics and biology of placenta-derived EVs, and discuss the challenges and opportunities of placenta-derived EVs as part of diagnostic tests for placental complications focusing on Bart’s hydrop fetalis.

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Section: Placenta-derived Evs As Hb Bart’s Liquid Biopsy: Challenges ...mentioning

confidence: 99%

Placenta-Derived Extracellular Vesicles in Pregnancy Complications and Prospects on a Liquid Biopsy for Hemoglobin Bart’s Disease

Chaemsaithong

Luewan

Taweevisit

et al. 2023

IJMS

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“…Heparin is typically continued until the day before angiography; thus, should angiography be available immediately, then holding off subcutaneous heparin allows for intravenous heparin during the procedure. There is emerging evidence that clopidogrel is safe in pregnancy, and usually this would be loaded as 600 mg (75 mg subsequently) 20 . The use of antiplatelets can be reviewed at the time of angiography when decisions regarding stent requirements have been made.…”

Section: Managementmentioning

confidence: 99%

“…Care should be individualised. There is insufficient evidence for the use of any other antiplatelet agents 20, 21 …”

Section: Managementmentioning

confidence: 99%

Acute coronary syndromes in pregnancy: a literature review

Freeman

Squire

Herrey³

et al. 2023

The Obstetric & Gynaecologis

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Maternal mortality from cardiovascular disease has not improved in almost 20 years; this contrasts to significant sustained improvement in cardiovascular outcomes in the nonpregnant population, particularly regarding acute coronary syndrome (ACS). Many of the women who died in recent MBRRACE-UK reports presented with cardiac symptoms and signs, but this was not always recognised upon clinical review. The incidence of ACS is increasing alongside advancing maternal age, with an accompanying increased prevalence of typical and pregnancy-specific cardiac risk factors. Early involvement of senior clinicians and a multidisciplinary approach is crucial for improving maternal outcomes.Counselling women on long term prognosis and implications for future pregnancy is vital. Learning objectivesTo be aware of the latest data for ACS in pregnancy, including the changing trends in prevalence of this condition and the suggested reasoning behind this. To understand the various presentations of ACS in pregnancy and its differential diagnosis. To understand the possible investigation and management of ACS in pregnancy in a multidisciplinary setting.

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“…In a recent systematic review, clopidogrel exposure in pregnancy was not found to be associated with an increased risk of major congenital malformations. 81 However, data on use of other antiplatelet agents in pregnancy, such as ticagrelor, remains limited.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Preventive Approaches in Women's Neurology: Prepartum, Pregnancy, and Postpartum

2022

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Women's neurology is the subspecialty within neurology concerned with the distinct healthcare needs of women. In this article, we review current literature and expert management strategies regarding disease-specific neurologic concerns of women, with an emphasis on issues related to contraception, pregnancy, and lactation. Health conditions that we discuss in this article include epilepsy, headache, stroke, multiple sclerosis, and Chiari I malformation. Current findings on neurologic disease in women suggest that many women with neurologic disease can safely manage their disease during pregnancy and have healthy children, though pregnancy planning is important in many conditions to mitigate risks and effective contraceptive management is important when pregnancy prevention is desired.

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Antiplatelet therapy in pregnancy: A systematic review

Cited by 15 publications

References 47 publications

Placenta-Derived Extracellular Vesicles in Pregnancy Complications and Prospects on a Liquid Biopsy for Hemoglobin Bart’s Disease

Placenta-Derived Extracellular Vesicles in Pregnancy Complications and Prospects on a Liquid Biopsy for Hemoglobin Bart’s Disease

Acute coronary syndromes in pregnancy: a literature review

Preventive Approaches in Women's Neurology: Prepartum, Pregnancy, and Postpartum

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