Pre-eclampsia screening in the first trimester – preemptive action to prevent the peril
| Autor: | Rinshi Abid Elayedatt, Seneesh Kumar Vikraman |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
03 medical and health sciences 0302 clinical medicine Pre-Eclampsia Pregnancy medicine Humans 030212 general & internal medicine reproductive and urinary physiology Placenta Growth Factor Fetus 030219 obstetrics & reproductive medicine Eclampsia Obstetrics business.industry Uterine artery doppler Infant Newborn Obstetrics and Gynecology Bayes Theorem medicine.disease female genital diseases and pregnancy complications Pregnancy Trimester First Uterine Artery First trimester Action (philosophy) embryonic structures Pediatrics Perinatology and Child Health Female business Biomarkers Low dose aspirin |
| Zdroj: | The Journal of Maternal-Fetal & Neonatal Medicine. 35:1808-1816 |
| ISSN: | 1476-4954 1476-7058 |
| DOI: | 10.1080/14767058.2020.1767059 |
| Popis: | Pre-eclampsia complicating 2–5% of pregnancies is an obstetrical syndrome associated with deleterious short-and long-term consequences to the gravid women, the fetus and the neonate. Majority of the obstetrical complications occur in early pre-eclampsia (requiring delivery 1:100 for pre-eclampsia developing before 37 weeks (preterm pre-eclampsia) is regarded as screen positive. Aspirin at a dose of 150 mg at bedtime given to screen positive subjects is associated with a significant reduction of preterm pre-eclampsia and early pre-eclampsia. The intervention is now supported by a well conducted randomized trial and metanalysis data. Aspirin acts by diminishing stores of constitutive cyclooxygenase enzyme in the non-nucleated platelets without disturbing systemic prostaglandin production. Selective use of aspirin in screen positive women is associated with a very low incidence of adverse maternal, fetal and neonatal side effects. The screening protocol can be applied to twin pregnancies albeit minor differences. Hence, screening for pre-eclampsia in first trimester, which is now endorsed by the federation of international obstetrical and gynecological societies, should be offered universally to all women at 11 to 13 + 6 weeks of gestation, followed by the administration of aspirin and serial maternal-fetal surveillance in the screen positive woman. |
| Databáze: | OpenAIRE |
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