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INTRAUTERINE
GROWTH RESTRICTION |
Am J Obstet Gynecol. 1988 Sep;159(3):681-5.
Low-dose aspirin therapy improves fetal weight in umbilical placental
insufficiency.
Trudinger BJ, Cook CM, Thompson RS, Giles WB, Connelly A.
Department of Obstetrics and Gynaecology, University of Sydney, Westmead
Hospital, New South Wales, Australia.
A randomized, placebo-controlled, double-blind trial was carried out to
evaluate the fetal benefits of low-dose aspirin (150 mg/day) as a treatment
of placental insufficiency during the last trimester of pregnancy. Forty-six
women referred for study because there was concern about fetal welfare were
found to have an elevated umbilical artery wave form systolic/diastolic
ratio. Mothers with severe hypertension were excluded because fetal
condition would not necessarily be the dominant determinant of obstetric
decision making. A distinction was made between a high systolic/diastolic
ratio (greater than 95th but less than 99.95th percentile) and an extreme
systolic/diastolic ratio (greater than 99.95th percentile). There were 34
patients in the high ratio group and 12 in the extreme group. Aspirin
therapy was associated with an increase in birth weight (mean difference 526
gm [p less than 0.02]), head circumference (1.7 cm [p less than 0.025]), and
placental weight (136 gm [p less than 0.02]) in those patients with a high
initial umbilical artery systolic/diastolic ratio. For the 12 women with an
extreme initial systolic/diastolic ratio, aspirin therapy did not result in
a significantly different pregnancy outcome.
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