ASPIRIN DURING PREGNANCY - INDICATIONS AN D MODALITIES FROM RECENT TRIALS

Aspirin, an inhibitor of cyclo-oxygenase, is prescribed in a number of conditions related to abnormal production of prostaglandins including gravidic hypertension. Results of the most recent trials demonstrate that in patients with a past history of pre-eclampsia or intra-uterine growth retardation, a pathological Doppler examination of the uterus, a pathological angiotensin test or an antiphospholipid syndrome, pres cription of aspirin at the dose of 100 mg/day can prevent recurrence o r development of pre-eclampsia or intra-uterine growth retardation. Tr eatment should begin as soon as possible during pregnancy, certainly b efore development of clinical manifestations. After history taking and identification of possible contraindications, bleeding time (Ivy meth od) is recorded before and after prescription and should be lower than 8 minutes. In case bleeding time exceeds 10 minutes 10 to 15 days aft er initiating aspirin, doses may be reduced to 50 mg per day or even 5 0 mg every two or three days to reach the target level. Treatment shou ld generally be continued up to 36 weeks gestation.