[CG] Aspirin - antenatal use of aspirin for the prevention of pre-eclampsia and/or SGA

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The NICE Guideline for Hypertension in pregnancy recommends the use of aspirin for the prevention of Pre-Eclampsia.  A recent meta-analysis has suggested a dose of 150mg daily, taken at night, to be most beneficial.  

RISK FACTORS FOR PRE‐ECLAMPSIA

HIGH

  • Hypertensive disease during a previous pregnancy
  • Chronic hypertension
  • Chronic renal disease
  • Autoimmune disease such as SLE or antiphospholipid syndrome
  • Diabetes – type 1 or type 2
  • Placental histology confirming placental dysfunction in a previous pregnancy**

MODERATE

  • First pregnancy
  • Age ≥ 40 years
  • Pregnancy interval >10 years
  • BMI ≥ 35 at first visit
  • Family history of Pre-Eclampsia
  • Multiple pregnancy
  • PAPP-A <0.4MoM

IF AT LEAST ONE HIGH OR TWO MODERATE RISK FACTORS THEN ADVISE  ASPIRIN (150mg) orally once daily at night FROM 12+0 WEEKS UNTIL DELIVERY OR 16 WEEKS IF REQUIRED FOLLOWING PAPP-A RESULT

**previous pregnancy complicated with one of the following: Birthweight <3rd centile/Birthweight <10th centile with abnormal umbilical Artery Doppler or uterine Artery Doppler/Stillbirth

Contraindications: previous or active peptic ulceration, haemophilia, severe cardiac failure

Hypersensitivity: Aspirin and other NSAIDs are contra-indicated in patients with a history of hypersensitivity to aspirin or any other NSAID – which includes those in whom asthma, angioedema, urticarial or rhinitis have been precipitated by aspirin or any NSAID.

Last reviewed: 07 February 2022

Next review: 01 June 2024

Author(s): Ann Duncan

Version: 9

Approved By: Obstetrics Governance Group GGC

Document Id: 341