Impact of aspirin on trophoblastic invasion in women with abnormal uterine artery Doppler at 11–14 weeks: a randomized controlled study

Abstract

In women with defective trophoblastic invasion, as reflected by abnormal UtA Doppler, low-dose aspirin started in the first trimester does not have a significant effect on UtA impedance as pregnancy progresses; however, the study was underpowered to detect potential small effects . Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Impact of low‐dose aspirin on adverse perinatal outcome: meta‐analysis and meta‐regression

“…Following review of the abstracts, 119 potentially suitable trials were selected for full review. Of these, 40 studies involving 34 807 participants, met the inclusion criteria and were included in the final analysis (Figure ).…”

“…None of the included studies reported on intrapartum fetal distress as an outcome. Due to the limited number of studies reporting the outcomes of operative vaginal birth, emergency CS for intrapartum fetal distress and birth asphyxia, these outcomes were not included in the meta‐analysis, and the individual study findings from the 10 studies reporting on these outcomes are presented in Table S1. Three studies reported on operative‐vaginal‐delivery rate, with all showing a reduced, albeit non‐significant, risk among women taking LDA.…”

“…Three studies reported on operative‐vaginal‐delivery rate, with all showing a reduced, albeit non‐significant, risk among women taking LDA. Four studies reported as an outcome, emergency CS for intrapartum fetal distress, of which three showed a non‐significant increase in risk, and one demonstrated a non‐significant risk reduction in women taking LDA. Birth asphyxia/acidosis was reported in five studies, however, in one study it was defined as either cord artery pH < 7.15 or base excess < −7 mmol/L or 5‐min Apgar score < 6, in another as base excess > 90 th centile (12 mEq/L) and in a third as cord pH < 7.15, while it was not defined in the other two studies.…”

“…Four studies reported as an outcome, emergency CS for intrapartum fetal distress, of which three showed a non‐significant increase in risk, and one demonstrated a non‐significant risk reduction in women taking LDA. Birth asphyxia/acidosis was reported in five studies, however, in one study it was defined as either cord artery pH < 7.15 or base excess < −7 mmol/L or 5‐min Apgar score < 6, in another as base excess > 90 th centile (12 mEq/L) and in a third as cord pH < 7.15, while it was not defined in the other two studies. Three of the studies showed a non‐significant increase whilst the remaining two showed a non‐significant reduction in the risk of birth asphyxia/acidosis in women receiving LDA.…”

First‐trimester and combined first‐ and second‐trimester prediction of small‐for‐gestational age and late fetal growth restriction

“…The ultimate aim of screening is to identify patients for whom timely intervention may alter the natural progression of the disease. Although late FGR has not been specifically addressed, pooled data from randomized trials show that early administration of low-dose aspirin in women at high risk for pre-eclampsia can reduce the risk for fetal/neonatal weight < 10 th centile (pooled relative risk (RR) 0.76; 95% CI, 0.65-0.89) [29][30][31][32][33][34][35][36] and for fetal/neonatal weight < 3 rd centile (pooled RR 0.7; 95% CI, 0.49-0.99) 29,30,37,38 . Therefore, contingent screening enhances recognition of late FGR fetuses, but effective first-trimester detection would be needed for their potential prevention.…”