LOW-DOSE ASPIRIN THERAPY AND PLACENTAL PATHOLOGY IN WOMEN WITH POOR PRIOR PREGNANCY OUTCOMES

PROBLEM: To determine if low dose aspirin therapy improves placental h istology in women with a prior complicated pregnancy demonstrating ute rine vascular pathology. METHOD: A retrospective chart review identifi ed patients with a prior complicated pregnancy with placental changes showing uterine vascular pathology (control pregnancy, CP). In the tre ated pregnancy (TP), 81 mg/day of ASA was started prior to 10 weeks. P lacental reports from the CP and TP were reviewed. Pregnancy outcomes and placental histology from the CP were compared to the TP for each p atient. RESULTS: Thirteen patients were enrolled. The majority of pati ents (8/13, 61.5%) exhibited recurrent, histologic evidence of uterine vascular pathology in the TP. The TP was more likely to be uncomplica ted (P < 0.05), delivered after 36 weeks (P < 0.05), and result in the delivery of a viable infant (P < 0.05) compared to the CP. CONCLUSION S: Despite an improvement in outcomes in the aspirin treated pregnancy , histologic evidence of uterine vascular pathology persisted in the m ajority of women with a prior complicated pregnancy demonstrating simi lar placental lesions. Abnormal placental histology may be useful in i dentifying a group of women with poor obstetrical histories who could benefit from low-dose aspirin therapy.