Could Aspirin Treatment Modify the Assessment of the Uterine Arteries?

Abstract

Objective To analyze whether acetylsalicylic (ASA) intake modifies the mean uterine arteries pulsatility index (UtA-PI) at the 2nd or 3rd trimester in a cohort of pregnant women with abnormal mean UtA-PI at between 11 and 14 weeks of gestation. Methods This is a retrospective cohort study. Singleton pregnancies with abnormal mean UtA-PI at between 11 and 14 weeks of gestation were studied. The participants were divided into 3 groups: 1) If the participant did not take ASA during pregnancy; 2) If the participant took ASA before 14 weeks of gestation; and 3) If the participant took ASA after 14 weeks of gestation. The mean UtA-PI was evaluated at the 2nd and 3rd trimesters, and it was considered to improve when it decreased below the 95th percentile. The prevalence ratio (PR) and the number needed to treat (NNT) were calculated. Results A total of 72 participants with a mean UtA-PI > 95th percentile at the 1st trimester of gestation were evaluated. Out of the 18 participants who took ASA, 8 participants started it before 14 weeks of gestation and 10 after. A total of 33.3% of these participants had improved the mean UtA-PI at the 2nd and 3rd trimesters of gestation, although it was not statistically significant (p = 0.154). The prevalence ratio was 0.95 (95% confidence interval [CI]: 0.31–1.89), but between the 1st and 2nd trimesters of gestation, the PR was 0.92 (95%CI: 0.21–0.99) and it was statistically significant. Conclusion The present work demonstrates a modification of the mean UtA-PI in participants who took ASA compared with those who did not. It is important to check if ASA can modify the normal limits of uterine arteries because this could have an impact on surveillance.

ASPRE trial: effects of aspirin on mean arterial blood pressure and uterine artery pulsatility index trajectories in pregnancy

“…Whilst no effects of aspirin on MAP were observed, aspirin initiated in the first trimester led to a more pronounced decrease in UtA resistance before 20 weeks of gestation compared with placebo. This finding is in line with those of two previous smaller studies 8,29 . Conversely, a previous RCT of 150 mg aspirin vs placebo including 155 participants with UtA-PI > 95 th percentile at 11-14 weeks published before the ASPRE trial showed no significant changes in UtA-PI at 28 weeks of gestation 30 .…”

Higher PAPP-A Values in Pregnant Women Complicated with Preeclampsia Than with Gestational Hypertension

“…Because of that, there is the hypothesis that women who have high risk of PE perhaps did not develop it because they took ASA during pregnancy. This treatment could have changed the outcome findings, so the conclusions must be very careful when outcomes are measured; perhaps final outcomes had been more serious if this prophylactic treatment would not have ordered at the beginning of the pregnancy [ 48 ].…”