Pre-eclampsia primary prevention: Difference between revisions
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{{Pre-eclampsia}} | {{Pre-eclampsia}} | ||
{{CMG}}; {{AE}} {{Sara.Zand}} | {{CMG}}; {{AE}} {{Sara.Zand}} | ||
==Overview== | |||
*Effective measures for the primary prevention of [[preeclampsia ]] include administration of low dose [[aspirin]] (75-162 mg/day) before the 16th week of [[pregnancy]] and [[calcium supplement]](1.2-2.5 g/day), especially in the high risk patients . | |||
== Primary prevention == | |||
*Effective measures for the primary prevention of [[preeclampsia ]] include administration of low dose [[aspirin]] (75-162 mg/day) before the 16th week of [[pregnancy]] and [[calcium supplement]](1.2-2.5 g/day), especially in the high risk patients .<ref name="HofmeyrLawrie2018">{{cite journal|last1=Hofmeyr|first1=G Justus|last2=Lawrie|first2=Theresa A|last3=Atallah|first3=Álvaro N|last4=Torloni|first4=Maria Regina|title=Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems|journal=Cochrane Database of Systematic Reviews|year=2018|issn=14651858|doi=10.1002/14651858.CD001059.pub5}}</ref><ref name="RolnikWright2017">{{cite journal|last1=Rolnik|first1=Daniel L.|last2=Wright|first2=David|last3=Poon|first3=Liona C.|last4=O’Gorman|first4=Neil|last5=Syngelaki|first5=Argyro|last6=de Paco Matallana|first6=Catalina|last7=Akolekar|first7=Ranjit|last8=Cicero|first8=Simona|last9=Janga|first9=Deepa|last10=Singh|first10=Mandeep|last11=Molina|first11=Francisca S.|last12=Persico|first12=Nicola|last13=Jani|first13=Jacques C.|last14=Plasencia|first14=Walter|last15=Papaioannou|first15=George|last16=Tenenbau Gavish|first16=Kinneret|last17=Meiri|first17=Hamutal|last18=Gizurarson|first18=Sveinbjorn|last19=Maclagan|first19=Kate|last20=Nicolaides|first20=Kypros H.|title=Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia|journal=New England Journal of Medicine|volume=377|issue=7|year=2017|pages=613–622|issn=0028-4793|doi=10.1056/NEJMoa1704559}}</ref><ref name="MayrinkCosta2018">{{cite journal|last1=Mayrink|first1=J.|last2=Costa|first2=M. L.|last3=Cecatti|first3=J. G.|title=Preeclampsia in 2018: Revisiting Concepts, Physiopathology, and Prediction|journal=The Scientific World Journal|volume=2018|year=2018|pages=1–9|issn=2356-6140|doi=10.1155/2018/6268276}}</ref> | |||
*In a recent clinical trial, there was 62% reduction in the occurrence of [[preeclampsia]] in patients received 150 mg aspirin daily. | |||
* There is not strong evidence about the effectiveness of [[vitamin C]], [[vitamin E ]], [[folic acid]] , [[sodium restriction]] for prevention of [[preeclampsia]].<ref name="pmid18254042">{{cite journal |vauthors=Rumbold A, Duley L, Crowther CA, Haslam RR |title=Antioxidants for preventing pre-eclampsia |journal=Cochrane Database Syst Rev |volume= |issue=1 |pages=CD004227 |date=January 2008 |pmid=18254042 |pmc=6718237 |doi=10.1002/14651858.CD004227.pub3 |url=}}</ref><ref name="OstadrahimiMohammad-Alizadeh2016">{{cite journal|last1=Ostadrahimi|first1=Alireza|last2=Mohammad-Alizadeh|first2=Sakineh|last3=Mirgafourvand|first3=Mozhgan|last4=Yaghoubi|first4=Sina|last5=Shahrisa|first5=Elham|last6=Farshbaf-Khalili|first6=Azizeh|title=Effects of Fish Oil Supplementation on Gestational Diabetes Mellitus (GDM): A Systematic Review|journal=Iranian Red Crescent Medical Journal|volume=18|issue=11|year=2016|issn=2074-1804|doi=10.5812/ircmj.24690}}</ref> | |||
*[[Low molecular weight heparin]] is not recommended for prevention of [[preeclampsia]]. | |||
== Indications of [[asprin]] prophylactic use in [[pregnancy]] == | |||
<ref>{{cite journal|doi=10.1097/AOG.0000000000003891.}}</ref> | |||
{| class="wikitable" | |||
|- | |||
| Risk level || Risk factors || Recommendation | |||
|- | |||
| High risk || *Previous [[preeclampsia]] | |||
* [[Multifetal gestation]] | |||
* [[Chronic hypertension]] | |||
*Type 1 or 2 [[diabetes]] | |||
* [[Renal disease]] | |||
* [[Autoimmune disease]] (systemic lupus | |||
erythematosus, antiphospholipid | |||
syndrome) | |||
|| Starting low dose of [[asprin]] if the patient has one or more of these risk factors | |||
|- | |||
| Moderate || | |||
* [[Nulliparity]] | |||
* [[Obesity]] ([[body mass index]] > 30) | |||
* [[Family history]] of [[preeclampsia]] (mother or | |||
sister) | |||
* Sociodemographic characteristics (African | |||
American race, [[low]] socioeconomic status) | |||
*Age≥ 35 years old | |||
* Previous history factors of: | |||
:*[[low birth weight]] | |||
:* [[small for gestational age]] | |||
:*Previous adverse [[pregnancy]] outcome | |||
:*More than 10-year [[pregnancy]] interval | |||
|| Starting low-dose [[aspirin]] if the patient has | |||
two or more of these moderate-risk factors | |||
|- | |||
| Low risk || Previous uncomplicated full term [[delivery]] || NO recommended [[aspirin]] | |||
|} | |||
==References== | ==References== | ||
| Line 24: | Line 55: | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
Latest revision as of 21:13, 7 November 2020
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Pre-eclampsia Microchapters |
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Pre-eclampsia primary prevention On the Web |
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American Roentgen Ray Society Images of Pre-eclampsia primary prevention |
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Risk calculators and risk factors for Pre-eclampsia primary prevention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2]
Overview
- Effective measures for the primary prevention of preeclampsia include administration of low dose aspirin (75-162 mg/day) before the 16th week of pregnancy and calcium supplement(1.2-2.5 g/day), especially in the high risk patients .
Primary prevention
- Effective measures for the primary prevention of preeclampsia include administration of low dose aspirin (75-162 mg/day) before the 16th week of pregnancy and calcium supplement(1.2-2.5 g/day), especially in the high risk patients .[1][2][3]
- In a recent clinical trial, there was 62% reduction in the occurrence of preeclampsia in patients received 150 mg aspirin daily.
- There is not strong evidence about the effectiveness of vitamin C, vitamin E , folic acid , sodium restriction for prevention of preeclampsia.[4][5]
- Low molecular weight heparin is not recommended for prevention of preeclampsia.
Indications of asprin prophylactic use in pregnancy
| Risk level | Risk factors | Recommendation |
| High risk | *Previous preeclampsia
erythematosus, antiphospholipid syndrome) |
Starting low dose of asprin if the patient has one or more of these risk factors |
| Moderate |
sister)
American race, low socioeconomic status)
|
Starting low-dose aspirin if the patient has
two or more of these moderate-risk factors |
| Low risk | Previous uncomplicated full term delivery | NO recommended aspirin |
References
- ↑ Hofmeyr, G Justus; Lawrie, Theresa A; Atallah, Álvaro N; Torloni, Maria Regina (2018). "Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems". Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD001059.pub5. ISSN 1465-1858.
- ↑ Rolnik, Daniel L.; Wright, David; Poon, Liona C.; O’Gorman, Neil; Syngelaki, Argyro; de Paco Matallana, Catalina; Akolekar, Ranjit; Cicero, Simona; Janga, Deepa; Singh, Mandeep; Molina, Francisca S.; Persico, Nicola; Jani, Jacques C.; Plasencia, Walter; Papaioannou, George; Tenenbau Gavish, Kinneret; Meiri, Hamutal; Gizurarson, Sveinbjorn; Maclagan, Kate; Nicolaides, Kypros H. (2017). "Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia". New England Journal of Medicine. 377 (7): 613–622. doi:10.1056/NEJMoa1704559. ISSN 0028-4793.
- ↑ Mayrink, J.; Costa, M. L.; Cecatti, J. G. (2018). "Preeclampsia in 2018: Revisiting Concepts, Physiopathology, and Prediction". The Scientific World Journal. 2018: 1–9. doi:10.1155/2018/6268276. ISSN 2356-6140.
- ↑ Rumbold A, Duley L, Crowther CA, Haslam RR (January 2008). "Antioxidants for preventing pre-eclampsia". Cochrane Database Syst Rev (1): CD004227. doi:10.1002/14651858.CD004227.pub3. PMC 6718237 Check
|pmc=value (help). PMID 18254042. - ↑ Ostadrahimi, Alireza; Mohammad-Alizadeh, Sakineh; Mirgafourvand, Mozhgan; Yaghoubi, Sina; Shahrisa, Elham; Farshbaf-Khalili, Azizeh (2016). "Effects of Fish Oil Supplementation on Gestational Diabetes Mellitus (GDM): A Systematic Review". Iranian Red Crescent Medical Journal. 18 (11). doi:10.5812/ircmj.24690. ISSN 2074-1804.
- ↑ . doi:10.1097/AOG.0000000000003891. Check
|doi=value (help). Missing or empty|title=(help)