Effects of aspirin on placenta and perinatal outcomes in patients with poor obstetric history
Effects of aspirin on placenta and perinatal outcomes in patients with poor obstetric history
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阿司匹林对不良产科病史患者胎盘和围产期结局的影响
DOI：
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发表时间：
2006
影响因子：
2.6
通讯作者：
E. Kuşçu
中科院分区：
文献类型：
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作者：
E. Tarım;N. Bal;E. Kılıçdağ;F. Kayaselçuk;T. Bağış;E. Kuşçu
目的：本研究的目的是比较低剂量阿司匹林治疗对有不良产科史的患者的胎盘和围生期的影响，如先兆子痫，宫内发育迟缓（IUGR）在以前的怀孕。研究设计：这项回顾性研究的86名孕妇之间进行了2002年4月至2005年6月。本研究共检查胎盘364例，选择有宫内发育迟缓、子痫前期等不良生育史的孕妇。然后将患者分为三组;第1组（n = 30）由既往妊娠无风险的女性组成;第2组（n = 27）由产科史较差的患者组成（例如，组3（n = 29）中的患者具有不良的产科史而没有任何治疗（患者在妊娠14周后开始随访）。第2组患者在尿妊娠试验呈阳性后立即接受低剂量阿司匹林（80 mg/天）治疗。通常在妊娠34周时停止治疗。胎盘组织病理学检查，子宫胎盘血管病理特征及继发绒毛损害（如多余血管的纤维素样坏死、绒毛梗死、严重增加的绒毛纤维化、严重增加的合体滋养层打结、血管腔闭塞、严重增加的绒毛血管过多）以及涉及凝血的病变（如绒毛周围纤维蛋白沉积过多、子宫胎盘血管内多发闭塞性血栓、无血管绒毛）。结果：两组产妇年龄、孕早期体重指数和分娩情况无显著差异。各组间胎盘重量、胎儿身高、体重、孕周、脐动脉pH值、pO 2、pCO 2和碱过剩状态也无显著差异。子痫前期的发生率分别为3.3%、7.4%、6.8%，IUGR的发生率分别为6.7%、11.1%、6.8%，两组比较差异无显著性（P > 0.05）。尽管第2组和第3组的所有病理学发现百分比较高，但这些差异无统计学意义。结论：当低剂量的阿司匹林，开始在怀孕初期的患者，产科史差，仍然有高频率的子宫胎盘血管和相关绒毛病变持续在胎盘床上。此外，它对这些患者的围产期结局没有有益的影响。
Objective: The aim of this study was to compare a low-dose aspirin treatment on placental and perinatal effects in the patients with poor obstetric history such as preeclampsia, intrauterine growth retardation (IUGR) in previous pregnancy. Study design: This retrospective study of 86 pregnant women was conducted between April 2002 and June 2005. In this study period 364 placentas were examined and the patients with poor obstetric history such as IUGR and preeclampsia were selected. Then the patients were assigned to three groups; group 1 (n = 30) was composed of women with no risk in previous pregnancy; group 2 (n = 27) was composed of patients with poor obstetric history (e.g., preeclampsia, IUGR) who were treated with aspirin and patients in group 3 (n = 29) had poor obstetric history without any treatment (patients who were started to follow-up after 14 weeks of gestation). Patients in group 2 were treated with a low-dose aspirin (80 mg/day) as soon as a urinary pregnancy test was positive. Treatment was usually stopped at 34 completed weeks of gestation. On histopathologic examination of the placenta, uteroplacental vascular pathologic features and secondary villous damage (such as fibrinoid necrosis of desidual vessels, villous infarct, severely increased villous fibrosis, severely increased syncytiotrophoblast knotting, obliteration of the vessel lumen, severely increased villous hypervascularity) and also lesions involving coagulation (such as excessive perivillous fibrin deposition, multiple occlusive thrombi in uteroplacental vessels, avascular villi ) were examined. Results: There were no significant differences between the groups with respect to maternal age, body mass index at the first trimester and delivery. Also there were no significant differences among groups with respect to placental weight, fetal height, weight, gestational week, umbilical artery pH, pO2, pCO2 and base excess status. The incidences of preeclampsia were 3.3, 7.4, 6.8% and the incidences of IUGR were 6.7, 11.1, 6.8% in the groups, respectively (P > 0.05 for both). Although the percentages of all pathologic findings were higher in groups 2 and 3, these differences were not statistically important. Conclusion: When low-dose aspirin is taken, starting at the beginning of pregnancy in patients with poor obstetric history, there are still high frequencies of uteroplacental vascular and related villous lesions persisted on placental bed. Also it has no beneficial effects on perinatal outcomes in these patients.
影响因子：
158.5
作者：
Caritis, S;Sibai, B;Thurnau, G
通讯作者：
Thurnau, G
DOI：
10.1016/s0002-9378(85)80223-4
发表时间：
1985-01-01
影响因子：
9.8
作者：
WALSH, SW
通讯作者：
WALSH, SW