Aspirin advised for pregnant women at risk of pre-eclampsia
Pregnant women at high risk of pre-eclampsia should take aspirin 75mg daily from 12 weeks gestation until the birth of the baby, the National Institute for Health and Clinical Excellence has recommended.
The off-licence recommendation is made for those considered at high risk due to having experienced hypertension in a previous pregnancy or having chronic kidney disease, type 1 or 2 diabetes, chronic hypertension or an autoimmune disease such as systemic lupus erythematosis or antiphospholipid syndrome.
The recommendation also applies to women who have at least two of the following moderate risk factors:
• First pregnancy
• 40 years of age or older
• A pregnancy interval of more than 10 years
• Body mass index of 35kg/m2 or greater
• Family history of pre-eclampsia; or multiple pregnancy
Diuretics, progesterone, nitric oxide donors (such as nitrates) and low molecular weight heparins should not be used to prevent hypertension disorders in pregnancy, the guidance states. In addition, NICE says that taking magnesium, folic acid, antioxidants (vitamins C and E), fish or algal oils or garlic supplements and restricting salt intake should not be recommended solely with the aim of preventing hypertensive disorders during pregnancy.
Women with chronic hypertension and who are planning pregnancy should be advised that angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) could cause congenital abnormalities. For those who have conceived, ACE inhibitors and ARBs should be stopped within two days of notification of pregnancy and alternatives offered.
The guidance also offers advice on the treatment of gestational hypertension and pre-eclampsia dependent on the patient’s blood pressure measurement.
Citation: The Pharmaceutical Journal URI: 11022639
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