Use of Daily Low-Dose Aspirin in Pregnancy for Women at High Risk of Preeclampsia at Georgetown Public Hospital Corporation

Abstract

Objective: To Determine what proportion of eligible high-risk women diagnosed with preeclampsia received low dose aspirin during antepartum care. Design & Methods: This was a retrospective chart review of all patients who delivered at Georgetown Public Hospital Corporation between September to December 2017 and were diagnosed with a hypertensive disorder in pregnancy. The primary outcome was the fraction of women diagnosed with preeclampsia, eclampsia or HELLP syndrome who met the U.S. Preventive Task Force criteria to be started on aspirin and were started on aspirin between 12 and 28 weeks of gestation. Maternal secondary outcomes included: Intensive care unit admissions, end organ injury, placental abruption and death. Neonatal secondary outcomes included: Neonatal intensive care unit admissions, fetal growth restriction, preterm births, stillbirths and neonatal death. Data was organised and analysed in Microsoft Excel 2016. Results: Of the 2,452 deliveries, 2,160 (88%) charts were found and reviewed. 14.3% were diagnosed with a hypertensive disorder in pregnancy. Of these, 37% had preeclampsia, eclampsia or HELLP syndrome. Among these, 36.8% met criteria to receive low dose aspirin antepartum but only 4.8% received aspirin. Of the secondary outcomes, one death occurred because of a haemorrhagic CVA. 42.1% of neonates were born prematurely of which 4 were stillbirths and 4 were neonatal deaths. Conclusions; The routine use of a low dose of aspirin among pregnant women who met the criteria to be started on was low. Recommendations: All women should be screened for the risk of developing preeclampsia and if needed, aspirin should be started between 12-28 weeks of gestation to get the best effects. Keywords: preeclampsia, aspirin in pregnancy, GPHC