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INTRAUTERINE GROWTH RESTRICTION |
Ginekol Pol. 1999 Mar;70(3):126-34.
Evaluation of the effectiveness of a low-dose aspirin in the treatment of
intrauterine growth retardation (IUGR)
Kalinka J, Sieroszewski P, Hanke W, Laudański T, Suzin J.
Kliniki Perinatologii Instytutu Ginekologii i Połoznictwa AM w Lodzi.
Objectives:
To evaluate the benefits of IUGR treatment by low doses of
acetylsalicylic acid (ASA) (1.5 mg/kg) compared to the standard method. The
study was based on the reports that aspirin at low doses shifts prostacyclin/tromboxan
A2 balance to the dominance of prostacyclin by inhibiting cyclooxygenase
activity in platelets, which results in the improvement of the utero-placental
circulation. MATERIAL AND METHOD: 31 pregnant women with diagnosed fetal
IUGR were randomly assigned to two groups, receiving either low-dose ASA (n
= 22) or the standard treatment (Sadamin, Partusisten, glucose i.v., amino
acids i.v.) for 10 days. Ultrasound examination of the biometric parameters
of the fetus (BPD, AC, FL) was performed and estimated fetal weight (EFW)
calculated before and after treatment. The birthweight of infants in the two
examined groups was compared.
Results:
The mean increase in EFW was higher
in the aspirin-treated group compared to that receiving standard treatment
(478 g vs 246 g, p < 0.05). In all the biometric parameters under study a
higher increase was noted in the group with aspirin treatment; however, the
difference was not statistically significant. The mean birthweight was found
to be higher in the ASA group as well (2856 g vs 2511 g). The frequency of
small-for-gestational-age (SGA) infants (birth weight below 10th percentile)
was lower in the ASA group than in the controls (27% vs 55%). The low-dose
aspirin therapy did not produce any adverse side effects either among
mothers of infants.
Conclusion:
The treatment with low doses of aspirin
reduces the proportion of SGA babies and increases birthweight in the case
of a diagnosed fetal growth retardation. Since the number of subjects in
this study was relatively small, further clinical trials are necessary to
evaluate the effectiveness of IUGR treatment by low-dose aspirin.
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