LOW-DOSE ASPIRIN IN NULLIPAROUS WOMEN - SAFETY OF CONTINUOUS EPIDURALBLOCK AND CORRELATION BETWEEN BLEEDING-TIME AND MATERNAL-NEONATAL BLEEDING COMPLICATIONS

OBJECTIVE: Our purpose was to determine the frequency and safety of th e use of epidural anesthesia and the correlation between bleeding time and maternal-neonatal bleeding complications in a group of pregnant w omen who participated in a multicenter trial of low-dose aspirin in pr egnancy. STUDY DESIGN: Data regarding type of anesthesia used for labo r and delivery were available in 1629 nulliparous women who were rando mly assigned at 13 to 27 weeks to receive 60 mg/day aspirin or a place bo. A total of 891 (55%) received epidural anesthesia, and the remaini ng 738 did not. RESULTS: Among the 891 women known to have received ep idural anesthesia, 451 were assigned to low-dose aspirin and 440 to pl acebo. There was no instance of bleeding related to epidural use. In a ddition, there were no differences in maternal and neonatal complicati ons between those receiving or not receiving epidural anesthesia. With in the group receiving epidural anesthesia there were no differences i n bleeding complications between those assigned to aspirin on placebo. One of the five centers also obtained bleeding times in 303 women (14 9 received aspirin and 154 received placebo). The mean +/- SD bleeding time in women assigned to low-dose aspirin was significantly higher t han in women assigned to placebo (6.99 +/- 2.95 minutes vs 5.99 +/- 2. 43 minutes, p = 0.004). In addition, the frequency of women having a b leeding time > 10 minutes was higher in the aspirin group (14.1% vs 5. 2%, p = 0.01). Interestingly, women who received an epidural anestheti c had a lower bleeding time than those not receiving an epidural (p = 0.003), irrespective of the treatment used. CONCLUSIONS: In women assi gned to low-dose aspirin there were no adverse effects related to epid ural anesthesia. In spite of an increased bleeding time in a subset of pregnant women assigned to low-dose aspirin, maternal-neonatal bleedi ng complications were not increased.