The Impact of Aspirin on Ultrasound Markers of Uteroplacental Flow in Low-Risk Pregnancy: Secondary Analysis of a Multicenter RCT

Cecilia Mulcahy; Fionnuala Mone; Peter McParland; Fionnuala Breathnach; Fiona Cody; John J. Morrison; John Higgins; Sean Daly; Samina Dornan; Amanda Cotter; Patrick Dicker; Elizabeth Tully; Fergal D. Malone; Fionnuala M. McAuliffe

doi:10.1055/s-0038-1675208

American Journal of Perinatology, Table of Contents

Am J Perinatol 2019; 36(08): 855-863
DOI: 10.1055/s-0038-1675208

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Impact of Aspirin on Ultrasound Markers of Uteroplacental Flow in Low-Risk Pregnancy: Secondary Analysis of a Multicenter RCT

Authors

Cecilia Mulcahy

¹Department of Fetal Medicine, National Maternity Hospital, Dublin, Ireland
Fionnuala Mone

²UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
Peter McParland

²UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
Fionnuala Breathnach

³Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
Fiona Cody

³Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
John J. Morrison

⁴Department of Obstetrics and Gynaecology, National University of Ireland, Galway, Ireland
John Higgins

⁵Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
Sean Daly

⁶Department of Obstetrics and Gynaecology, Coombe Women's and Infant's University Hospital, Dublin, Ireland
Samina Dornan

⁷Royal Jubilee Maternity Hospital, Belfast, United Kingdom
Amanda Cotter

⁸Department of Obstetrics and Gynaecology, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
Patrick Dicker

³Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
Elizabeth Tully

³Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
Fergal D. Malone

³Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
Fionnuala M. McAuliffe

²UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland

Abstract

Objective This article evaluates the effect of low-dose aspirin on uterine artery (UtA) Doppler, placental volume, and vascularization flow indices in low-risk pregnancy.

Study Design In this secondary analysis of the TEST randomized controlled trial, low-risk nulliparous women were originally randomized at 11 weeks to: (1) routine aspirin 75 mg; (2) no aspirin; and (3) aspirin based upon the preeclampsia Fetal Medicine Foundation screening test. UtA Doppler, three-dimensional (3D) placental volume, and vascularization flow indices were assessed prior to and 6 weeks postaspirin commencement.

Results A total of 546 women were included (aspirin n = 192, no aspirin n = 354). Between first and second trimesters, aspirin use was not associated with a change in UtA Doppler, placental volume, or vascular flow indices. There was no significant difference in the change in UtA Doppler pulsatility index (PI) Z-scores or notching (PI Z-score –0.2 vs. –0.2, p = 0.17), nor was there a significant change in placental volume Z-score and vascular flow indices (volume Z-score change: 0.74 vs. 0.62, p = 0.34).

Conclusion Low-dose aspirin commenced at 11 weeks in low-risk women does not appear to improve uterine and placental perfusion or placental volume. Any perceived effect on uteroplacental vasculature is not reflected in changes in placental volume nor uteroplacental flow as assessed by two-dimensional and 3D ultrasound.

Keywords

aspirin - uteroplacental - uterine artery Doppler - placental volume - 3D ultrasound - three-dimensional power Doppler indices

Full Text

References

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