PREDICTION OF PREECLAMPSIA BY ABNORMAL UTERINE DOPPLER ULTRASOUND ANDMODIFICATION BY ASPIRIN

Objective To assess the effect of low dose aspirin on severe pre-eclam psia when given to women identified as high risk by abnormal uterine a rtery Doppler ultrasound. Design Women with abnormal uterine artery fl ow velocity waveforms were recruited to the CLASP trial at 24 weeks. A bnormal uterine artery waveforms, with a high resistance index or an e arly diastolic notch, were identified at the 18-22 week anomaly scan a nd confirmed at 24 weeks. Of those women with persistently abnormal wa veforms, 63 agreed to enter the CLASP trial. Three women were lost to follow up and five did not comply. Thus, 60 were randomised: 29 to pla cebo and 31 to low dose aspirin (60 mg daily) and analysis by intentio n to treat is reported. Results There were nine cases (29%) of pre-ecl ampsia in the aspirin group and twelve (41%) in the placebo group (odd s ratio (OR) 0.58, confidence interval (CI) 0.2-1.69, P = 0.32). Sever e pre-eclampsia developed in four women in the aspirin group and eleve n women in the placebo group (OR 0.24, CI 0.07-0.88, P = 0.03) and int rauterine growth retardation occurred in eight cases in the aspirin gr oup and twelve in the placebo group (OR 0.49, CI 0.17-1.47). The mean birthweight and gestation at delivery were 2.69 kg and 38.5 weeks in t he aspirin group and 2.38 kg and 37.4 weeks in the placebo group, neit her of which were statistically significant using the unpaired t test; P = 0.09 and P = 0.23, respectively. Conclusions In high risk pregnan cy low dose aspirin commenced at 24 weeks may reduce the incidence of severe pre-eclampsia.