Pharmacology and toxicology
Low-dosage treatment with 75-300 mg acetylsalicylic acid daily is prescribed for thrombosis prophylaxis and for the prevention of pre-eclampsia.
This therapy (preferably in combination with low molecular-weight heparins) is found to be effective in preventing recurrent pregnancy loss and other pregnancy complications in women with antiphospholipid syndrome, as in systemic lupus erythematosus (see also Chapter 2.9.2). Many studies indicate a benefit of low-dose aspirin, in combination with LMWHs or alone, in the treatment of high-risk thrombophilic pregnant women; other studies do not confirm these findings. In one meta-analysis, aspirin treatment seemed to have, for women with moderate and high risk, a small but significant effect on reducing the rate of preterm birth, but it did not reduce the rate of perinatal death (Kozer 2003). The use of low-dose aspirin for preventing recurrent pregnancy loss and other serious obstetrical complications in women with thrombophilia remains a subject for debate (Robertson 2005, Bates 2004, Gris 2004, Brenner 2003).
Many studies have looked at the use of 'low-dosage' treatment to prevent high blood pressure in pregnancy, and its consequences -such as, for instance, intrauterine growth delays (see Chapter 2.1.2 for further details). No adverse effects in the mother, fetus or newborn in association with the use of low-dose aspirin were observed.
Recommendation. 'Low-dose' treatment with acetylsalicylic acid can be used for appropriate indications.
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