Titration of Antiplatelet Treatment in Pregnant Women at Risk of Preeclampsia

M. H. F. Sullivan; N. A. C. Clark; M. de Swiet; C. Nelson-Piercy; M. G. Elder

doi:10.1055/s-0037-1615057

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1998; 79(04): 743-746
DOI: 10.1055/s-0037-1615057

Rapid Communication

Schattauer GmbH

Titration of Antiplatelet Treatment in Pregnant Women at Risk of Preeclampsia

M. H. F. Sullivan

¹From the Institute of Obstetrics and Gynaecology, Imperial College School of Medicine, Hammersmith Hospital, London, UK

,

N. A. C. Clark

¹From the Institute of Obstetrics and Gynaecology, Imperial College School of Medicine, Hammersmith Hospital, London, UK

,

M. de Swiet

²From the Institute of Obstetrics and Gynaecology, Queen Charlotte’s and Chelsea Hospital, London, UK

,

C. Nelson-Piercy

²From the Institute of Obstetrics and Gynaecology, Queen Charlotte’s and Chelsea Hospital, London, UK

,

M. G. Elder

¹From the Institute of Obstetrics and Gynaecology, Imperial College School of Medicine, Hammersmith Hospital, London, UK

› Author Affiliations

Abstract

Summary

We recruited 111 patients who were considered to be at significantly increased risk of preeclampsia on the basis of previous obstetric history or preexisting medical disorders. All patients were treated with low dose aspirin (75 mg/day) from the first occasion the patient attended the antenatal clinic, regardless of gestational age. If the maternal mean platelet volume (MPV) increased significantly (by >0.8 fl) from the baseline, antiplatelet treatment was increased. Five pregnancies were lost during the second trimester and 106 of the treated patients had live infants. The incidence of neonatal death (3/106 infants) was much lower than in the previous pregnancies in these patients (32/134 infants). Patients who were treated from the first trimester of pregnancy (group A, 89 patients) did substantially better than those treated from the second trimester (group B, 17 patients) as assessed by the incidence of pre-eclampsia or intrauterine growth restriction (IUGR), gestational age and birthweight at delivery. These data suggest that longitudinal monitoring of the MPV may identify the women who could benefit from increased antiplatelet treatment, and that antiplatelet treatment may be more effective when initiated in the first trimester rather than later in pregnancy.

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References

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