Опыт применения ацетилсалициловой кислоты с целью профилактики преэклампсии и эклампсии

Abstract

Aim. To analyze the own experience of using acetylsalicinic acid (ASA) 150 mg/d to prevent the development of preeclampsia (PE) and eclampsia according to the clinical recommendation. Design. Retrospective study. Material and methods. A retrospective analysis of medical records for 2019-2022 was carried out. The effect of taking ASA 150 mg/day on the frequency of PE and eclampsia development was studied. The program complex calculation of individual risk of PE was carried out based on the astraia software taking into account the results of ultrasound examination, biochemical screening, and maternal characteristics. Statistical analysis was carried out using the STATISTICA 13.3 package (Tibco, USA) and Microsoft Excel 2016. For data processing methods of descriptive statistics, comparative data analysis, non-parametric methods of mathematical statistics were used, the arithmetic mean (M), square average deviation (m) was calculated. The assessment of the statistical significance of differences in indicators in groups was carried out using the Mann-Whitney non-parametric criterion. In all cases of statistical analysis, the level of statistical significance p<0.05 was adopted. Results. The analysis of the frequency of PE and eclampsia development showed an increase in 2020-2021 (before the introduction of PE prophylaxis by prescribing ASA) an increase in frequency of moderate PE by 9.3%, severe by 28.8%. Against the background of prescribing ASA in 2020-2021, the previously existing hypertension decreased by 4.8%, severe PE – by 24.6%. The calculated high risk of developing PE in 2022 showed that pregnant women 35 years and older (92.1%) who had a pregnancy in the process of assisted reproductive technologies (67.0%), most of whom were pregnant for the first time, are leading in this group. Among the risk factors in pregnant women with severe PE, patients with the first pregnancy (41.3%), obesity (40%), and late reproductive age (40%) are more common. Hemodynamic disorders in 18-20+6 weeks in 20% of all pregnant women, in the third trimester (at 30-34 weeks) – in 53.2% of pregnant women. Conclusion. The dedication of additional criteria for determining the risk groups for the development of PE will allow the prevention of PE at the pregravidary stage and/or in the early stages of pregnancy, including for 12 weeks. The duration of ASA medication requires further study. Age over 30 years should be considered as an isolated risk factors. Key words: preeclampsia, risk factors, prophylaxis.