OGCO-C1.5 Low dose aspirin for prevention of pre-eclampsia

Question 1

What are considered high risk factors for using low dose aspirin (LDA) for prevention of pre-eclampsia?

Answer 1

• Chronic hypertension
• Pre-existing diabetes mellitus (Type 1 or Type 2)
• Chronic kidney disease
• Systemic lupus erythematosus
• Hypertensive disease during a previous pregnancy
• Antiphospholipid syndrome
• Multiple pregnancy
• Women who were screened positive at first trimester pre-eclampsia screening

Question 2

When should LDA 100mcg NOCTE be given for high risk patietns?

Answer 2

LDA100mg NOCTE should be initiated from 12 weeks gestation and before 16 weeks gestation for
women with one or more risk factor as stated above. Women should be evaluated for contraindication or precaution (e.g. asthma, peptic ulcer, gastritis, thrombocytopenia, hyperuricaemia) before prescription. LDA should be continued until 36 weeks gestation, unless pre-eclampsia is established before that.

Question 3

What is Mx for women with confirmed antiphospholipid syndrome?

Answer 3

They should be started on LDA when pregnancy test is positive and then low molecular weight heparin (prophylactic dose) when fetal viability is confirmed with ultrasound.

Question 4

Patient with previous early onset pre-eclampsia or previous severe fetal growth restriction, what should be tested?

Answer 4

Antiphospholipid syndrome