The Role of Aspirin in Preeclampsia Prevention: State of the Art

Detalhes bibliográficos
Autor(a) principal: Campos, Ana
Data de Publicação: 2015
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/6005
Resumo: Introduction: The role of acetyl salicylic acid (ASA or aspirin) in preeclampsia prevention and in other complications has been subject to studies and controversies for the last 30 years. The first research results concerning the role of placenta in preeclampsia have been published by the end of seventies and they showed an increase in the platelet activity and a prostaglandin synthesis disturbance, as a consequence of a deficient placentation. In the last twenty years of the XX century important studies were published on the aspirinprophylactic role in preeclampsia risk reduction.Material and Methods: To analyze published studies about Aspirin use for preeclampsia prevention and about the more adequate dosage to be administered, Medline was used for searching the most relevant prospective research papers on this subject in order to evaluate current evidence about the use of aspirin in this context. Relevant citations were extracted from Embase, PubMed and the Cochrane Central Register of Controlled Trials. We divided the studies in two groups; one with aspirine administration before 16 weeks and the other having a larger use, between the first and the third trimester.Results and Discussion: The first group of studies, with a lesser number of cases but an earlier time of administration until 16 weeks, concluded that a positive role of aspirine was possible in reducing severity of preeclampsia; the second group with a larger number of cases but less restricted conditions and timing of administration, had controversial results, with reduced positive actions of the drug. Meta-analysis of these published studies concluded that favorable results were associated to stricter criteria and ideal timing for startingthe drug.Conclusion: As we do not have other pharmacologic alternatives, low dosage of Aspirin between 80-150 mg a day in the first trimester and until 16 weeks, at evening time, is a possible choice in cases of risk, and is still contributing for an early preeclampsia risk reduction.
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spelling The Role of Aspirin in Preeclampsia Prevention: State of the ArtO Papel da Aspirina na Prevenção da Pré-Eclâmpsia: Estado da ArteAspirinPre-Eclampsia/prevention & control.AspirinaPré-eclâmpsia/prevenção e controlo.Introduction: The role of acetyl salicylic acid (ASA or aspirin) in preeclampsia prevention and in other complications has been subject to studies and controversies for the last 30 years. The first research results concerning the role of placenta in preeclampsia have been published by the end of seventies and they showed an increase in the platelet activity and a prostaglandin synthesis disturbance, as a consequence of a deficient placentation. In the last twenty years of the XX century important studies were published on the aspirinprophylactic role in preeclampsia risk reduction.Material and Methods: To analyze published studies about Aspirin use for preeclampsia prevention and about the more adequate dosage to be administered, Medline was used for searching the most relevant prospective research papers on this subject in order to evaluate current evidence about the use of aspirin in this context. Relevant citations were extracted from Embase, PubMed and the Cochrane Central Register of Controlled Trials. We divided the studies in two groups; one with aspirine administration before 16 weeks and the other having a larger use, between the first and the third trimester.Results and Discussion: The first group of studies, with a lesser number of cases but an earlier time of administration until 16 weeks, concluded that a positive role of aspirine was possible in reducing severity of preeclampsia; the second group with a larger number of cases but less restricted conditions and timing of administration, had controversial results, with reduced positive actions of the drug. Meta-analysis of these published studies concluded that favorable results were associated to stricter criteria and ideal timing for startingthe drug.Conclusion: As we do not have other pharmacologic alternatives, low dosage of Aspirin between 80-150 mg a day in the first trimester and until 16 weeks, at evening time, is a possible choice in cases of risk, and is still contributing for an early preeclampsia risk reduction.Introdução: O papel do ácido acetilsalicílico (AAS ou aspirina) na prevenção das complicações associadas à pré-eclâmpsia tem sido objeto de estudos e de controvérsias ao longo de 30 anos. Os primeiros trabalhos de investigação acerca do papel da placenta na génese da pré-eclâmpsia surgiram em finais dos anos 70 e assinalavam um aumento da atividade plaquetária e alteração da síntese das prostaglandinas, como consequência da deficiente adaptação da placenta. Ao longo dos últimos 20 anos do século XX, sucederam-se estudos de investigação acerca do papel profilático da aspirina na redução do risco de pré-eclâmpsia.Material e Métodos: Para analisar os trabalhos publicados sobre o uso da aspirina na prevenção da pré-eclâmpsia, bem como sobre a dose mais adequada e momento de administração, foram consultados apenas estudos prospetivos, revisões sistemáticas e meta-análises através das seguintes fontes pesquisa (PubMed, Cochrane, Embase). Os artigos citados foram considerados os mais relevantes. Os trabalhos foram divididos em dois grupos: no primeiro foram incluídos os trabalhos em que a aspirina era administrada até às 16 semanas e o segundo, com início de administração por um período mais alargado.Resultados e Discussão: No primeiro grupo, com menor número de casos, mas com início mais precoce de administração do fármaco, até às 16 semanas, concluiu-se que a aspirina poderia ter um papel positivo na redução de risco de gravidade da pré-eclâmpsia; o segundo grupo, com maior número de casos nos estudos, mas com condições menos restritas de entrada e de tempo de início do fármaco, teve resultados mais controversos. As meta-análises destes estudos concluíram que os resultados favoráveis estavam associadosàs condições de e momento da administração.Conclusão: Não existindo ainda alternativas ou fármacos que lhe possam ser associados, a aspirina em baixas doses (80 a 150 mg/ dia) ao deitar, iniciada no 1º trimestre e até às 16 semanas mantém-se um fármaco seguro, que tem contribuído para redução do risco de pré-eclâmpsia precoce, com as consequências que lhe estão associadas.Ordem dos Médicos2015-07-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/mswordapplication/mswordapplication/mswordapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/6005oai:ojs.www.actamedicaportuguesa.com:article/6005Acta Médica Portuguesa; Vol. 28 No. 4 (2015): July-August; 517-524Acta Médica Portuguesa; Vol. 28 N.º 4 (2015): Julho-Agosto; 517-5241646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/6005https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/6005/4428https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/6005/7555https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/6005/7556https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/6005/7579https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/6005/7802Campos, Anainfo:eu-repo/semantics/openAccess2022-12-20T11:04:41Zoai:ojs.www.actamedicaportuguesa.com:article/6005Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:14.956771Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv The Role of Aspirin in Preeclampsia Prevention: State of the Art
O Papel da Aspirina na Prevenção da Pré-Eclâmpsia: Estado da Arte
title The Role of Aspirin in Preeclampsia Prevention: State of the Art
spellingShingle The Role of Aspirin in Preeclampsia Prevention: State of the Art
Campos, Ana
Aspirin
Pre-Eclampsia/prevention & control.
Aspirina
Pré-eclâmpsia/prevenção e controlo.
title_short The Role of Aspirin in Preeclampsia Prevention: State of the Art
title_full The Role of Aspirin in Preeclampsia Prevention: State of the Art
title_fullStr The Role of Aspirin in Preeclampsia Prevention: State of the Art
title_full_unstemmed The Role of Aspirin in Preeclampsia Prevention: State of the Art
title_sort The Role of Aspirin in Preeclampsia Prevention: State of the Art
author Campos, Ana
author_facet Campos, Ana
author_role author
dc.contributor.author.fl_str_mv Campos, Ana
dc.subject.por.fl_str_mv Aspirin
Pre-Eclampsia/prevention & control.
Aspirina
Pré-eclâmpsia/prevenção e controlo.
topic Aspirin
Pre-Eclampsia/prevention & control.
Aspirina
Pré-eclâmpsia/prevenção e controlo.
description Introduction: The role of acetyl salicylic acid (ASA or aspirin) in preeclampsia prevention and in other complications has been subject to studies and controversies for the last 30 years. The first research results concerning the role of placenta in preeclampsia have been published by the end of seventies and they showed an increase in the platelet activity and a prostaglandin synthesis disturbance, as a consequence of a deficient placentation. In the last twenty years of the XX century important studies were published on the aspirinprophylactic role in preeclampsia risk reduction.Material and Methods: To analyze published studies about Aspirin use for preeclampsia prevention and about the more adequate dosage to be administered, Medline was used for searching the most relevant prospective research papers on this subject in order to evaluate current evidence about the use of aspirin in this context. Relevant citations were extracted from Embase, PubMed and the Cochrane Central Register of Controlled Trials. We divided the studies in two groups; one with aspirine administration before 16 weeks and the other having a larger use, between the first and the third trimester.Results and Discussion: The first group of studies, with a lesser number of cases but an earlier time of administration until 16 weeks, concluded that a positive role of aspirine was possible in reducing severity of preeclampsia; the second group with a larger number of cases but less restricted conditions and timing of administration, had controversial results, with reduced positive actions of the drug. Meta-analysis of these published studies concluded that favorable results were associated to stricter criteria and ideal timing for startingthe drug.Conclusion: As we do not have other pharmacologic alternatives, low dosage of Aspirin between 80-150 mg a day in the first trimester and until 16 weeks, at evening time, is a possible choice in cases of risk, and is still contributing for an early preeclampsia risk reduction.
publishDate 2015
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 28 No. 4 (2015): July-August; 517-524
Acta Médica Portuguesa; Vol. 28 N.º 4 (2015): Julho-Agosto; 517-524
1646-0758
0870-399X
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