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Am J Perinatol 2019; 36(08): 855-863
DOI: 10.1055/s-0038-1675208
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Impact of Aspirin on Ultrasound Markers of Uteroplacental Flow in Low-Risk Pregnancy: Secondary Analysis of a Multicenter RCT

Cecilia Mulcahy
1   Department of Fetal Medicine, National Maternity Hospital, Dublin, Ireland
,
Fionnuala Mone
2   UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
,
Peter McParland
2   UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
,
Fionnuala Breathnach
3   Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
,
Fiona Cody
3   Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
,
John J. Morrison
4   Department of Obstetrics and Gynaecology, National University of Ireland, Galway, Ireland
,
John Higgins
5   Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
,
Sean Daly
6   Department of Obstetrics and Gynaecology, Coombe Women's and Infant's University Hospital, Dublin, Ireland
,
Samina Dornan
7   Royal Jubilee Maternity Hospital, Belfast, United Kingdom
,
Amanda Cotter
8   Department of Obstetrics and Gynaecology, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
,
Patrick Dicker
3   Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
,
Elizabeth Tully
3   Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
,
Fergal D. Malone
3   Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
,
Fionnuala M. McAuliffe
2   UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
› Author Affiliations Funding This trial was funded by Perinatal Ireland, HRB, and the Mother and Baby Clinical Trials Network, HRB.
Further Information

Publication History

24 June 2018

13 September 2018

Publication Date:
05 November 2018 (online)

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Abstract

Objective This article evaluates the effect of low-dose aspirin on uterine artery (UtA) Doppler, placental volume, and vascularization flow indices in low-risk pregnancy.

Study Design In this secondary analysis of the TEST randomized controlled trial, low-risk nulliparous women were originally randomized at 11 weeks to: (1) routine aspirin 75 mg; (2) no aspirin; and (3) aspirin based upon the preeclampsia Fetal Medicine Foundation screening test. UtA Doppler, three-dimensional (3D) placental volume, and vascularization flow indices were assessed prior to and 6 weeks postaspirin commencement.

Results A total of 546 women were included (aspirin n = 192, no aspirin n = 354). Between first and second trimesters, aspirin use was not associated with a change in UtA Doppler, placental volume, or vascular flow indices. There was no significant difference in the change in UtA Doppler pulsatility index (PI) Z-scores or notching (PI Z-score –0.2 vs. –0.2, p = 0.17), nor was there a significant change in placental volume Z-score and vascular flow indices (volume Z-score change: 0.74 vs. 0.62, p = 0.34).

Conclusion Low-dose aspirin commenced at 11 weeks in low-risk women does not appear to improve uterine and placental perfusion or placental volume. Any perceived effect on uteroplacental vasculature is not reflected in changes in placental volume nor uteroplacental flow as assessed by two-dimensional and 3D ultrasound.

Keywords

aspirin - uteroplacental - uterine artery Doppler - placental volume - 3D ultrasound - three-dimensional power Doppler indices

Supplementary Material

 

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