Abstract
To analyze whether acetylsalicylic (ASA) intake modifies the mean uterine arteries pulsatility index (UtA-PI) at the 2nd or 3rd trimester in a cohort of pregnant women with abnormal mean UtA-PI at between 11 and 14 weeks of gestation. This is a retrospective cohort study. Singleton pregnancies with abnormal mean UtA-PI at between 11 and 14 weeks of gestation were studied. The participants were divided into 3 groups: 1) If the participant did not take ASA during pregnancy; 2) If the participant took ASA before 14 weeks of gestation; and 3) If the participant took ASA after 14 weeks of gestation. The mean UtA-PI was evaluated at the 2nd and 3rd trimesters, and it was considered to improve when it decreased below the 95th percentile. The prevalence ratio (PR) and the number needed to treat (NNT) were calculated. A total of 72 participants with a mean UtA-PI > 95th percentile at the 1st trimester of gestation were evaluated. Out of the 18 participants who took ASA, 8 participants started it before 14 weeks of gestation and 10 after. A total of 33.3% of these participants had improved the mean UtA-PI at the 2nd and 3rd trimesters of gestation, although it was not statistically significant (p = 0.154). The prevalence ratio was 0.95 (95% confidence interval [CI]: 0.31-1.89), but between the 1st and 2nd trimesters of gestation, the PR was 0.92 (95%CI: 0.21-0.99) and it was statistically significant. The present work demonstrates a modification of the mean UtA-PI in participants who took ASA compared with those who did not. It is important to check if ASA can modify the normal limits of uterine arteries because this could have an impact on surveillance.
Highlights
The present work demonstrates a modification of the mean UtA-uterine arteries pulsatility index (PI) in participants who took acetylsalicylic acid (ASA) compared with those who did not
A total of 78 participants of the main prospective study had the mean uterine arteries pulsatility index (UtA-PI) > 95th percentile, a total of 6 participants were excluded (5 participants who presented with late abortions and another who did not attend to the follow-up appointment)
Among the 72 participants evaluated, it was found that 18 took ASA (25%), only 8 of whom started ASA intake before 14 weeks, and 10 after 14 weeks. ►Table 1 compares the social and clinical characteristics of the women studied. ►Fig. 2 shows the mean UtA-PI of each trimester in each group
Summary
The measurement of the mean uterine arteries pulsatility index (UtA-PI) using the Doppler technique is an indirect validated indicator of trophoblastic invasion and placental perfusion and can be altered in the early stages of gestation.[9,10,11,12] Determination of the mean UtA-PI at the 1st trimester of gestation is one of the elements of an algorithm that combines maternal factors, mean arterial pressure (MAP), maternal serum pregnancy-associated plasma protein-A (PAPP-A) and placental growth factor (PlGF) This model detects $ 75% of the patients who will suffer preterm PE with a false positive rate of 10%.13–15. This model detects $ 75% of the patients who will suffer preterm PE with a false positive rate of 10%.13–15 it described that the combined screening early in the 3rd trimester (30 to 34 weeks) predicted almost all cases of preterm PE and half of term PE with a false positive rate of 5%.16
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