Evidence for acetylsalicylic acid (aspirin) in the prevention of preeclampsia: a narrative review

• Autor: Vigil-De Gracia, Paulino
• Formato: artículo
• Fecha de Publicación: 2022
• Institución: Sociedad Peruana de Obstetricia y Ginecología
• Repositorio: Revista Peruana de Ginecología y Obstetricia
• Lenguaje: español; inglés
• OAI Identifier: oai:ginecologiayobstetricia.pe:article/2453
• Enlace del recurso: https://ginecologiayobstetricia.pe/index.php/RPGO/article/view/2453
• Nivel de acceso: acceso abierto
• Materia: Preeclampsia; prevención; predicción; Doppler; Aspirina; Pre-eclampsia; prevention; prediction; Doppler effect; Aspirin

Objective: To describe the methods used to predict preeclampsia and how to preventit using low-dose acetylsalicylic acid (aspirin) according to the recommendationsof the main obstetrics and gynecology organizations. Methodology: We searchedPubMed and Cochrane Library from January 1, 2020, to May 1, 2022, using theterms “pre-eclampsia”, “hypertensive disorders in pregnancy” and “hypertensionand pregnancy”. We focused on the analyses and recommendations from the mostrecognized international obstetrics and gynecology organizations, independent ofthe original language. Results: For the prediction of preeclampsia, two strategies areused that aim to find the population at highest risk based on: 1) clinical findingsof risk for pre-pregnancy or pregnancy conditions, and 2) a multi-factor algorithmthat includes clinical findings, blood pressure, biomarker and uterine artery Doppler.Using both strategies, variable effectiveness of aspirin in preventing preeclampsiais found. The most effective dose range between 50-150 mg, with 81 mg being themost recommended at present. The dose of 150 mg per day has shown effectivenessin preeclampsia far from term; however, it is considered to have more side effects.Conclusions: The most prestigious and recognized obstetrics and gynecologyand health organizations recommend low-dose aspirin to prevent preeclampsia,preferably at the beginning of the second trimester of pregnancy and maintaineduntil 36-37 weeks.