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Can I Give Baby Aspirin to My Puppy After Surgery

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Commission on Obstetric Do

Guild for Maternal–Fetal Medicine:

This Committee Stance was developed past the Commission on Obstetric Practice in collaboration with commission member T. Flint Porter, MD, and the Society for Maternal–Fetal Medicine in collaboration with members Cynthia Gyamfi-Bannerman, Doctor, MS, and Tracy Manuck, MD.

Abstruse: Depression-dose aspirin has been used during pregnancy, about commonly to foreclose or delay the onset of preeclampsia. The American Higher of Obstetricians and Gynecologists issued the Hypertension in Pregnancy Task Force Report recommending daily depression-dose aspirin beginning in the late start trimester for women with a history of early on-onset preeclampsia and preterm delivery at less than 34 0/7 weeks of gestation, or for women with more than one prior pregnancy complicated past preeclampsia. The U.Southward. Preventive Services Task Force published a similar guideline, although the listing of indications for low-dose aspirin use was more expansive. Daily depression-dose aspirin apply in pregnancy is considered safe and is associated with a low likelihood of serious maternal, or fetal complications, or both, related to use. The American College of Obstetricians and Gynecologists and the Lodge for Maternal-Fetal Medicine support the U.S. Preventive Services Task Strength guideline criteria for prevention of preeclampsia. Low-dose aspirin (81 mg/day) prophylaxis is recommended in women at high hazard of preeclampsia and should be initiated betwixt 12 weeks and 28 weeks of gestation (optimally before sixteen weeks) and continued daily until delivery. Low-dose aspirin prophylaxis should be considered for women with more than one of several moderate risk factors for preeclampsia. Women at risk of preeclampsia are defined based on the presence of ane or more high-risk factors (history of preeclampsia, multifetal gestation, renal disease, autoimmune disease, blazon 1 or type 2 diabetes, and chronic hypertension) or more than than one of several moderate-risk factors (first pregnancy, maternal age of 35 years or older, a body mass index greater than thirty, family history of preeclampsia, sociodemographic characteristics, and personal history factors). In the absence of loftier risk factors for preeclampsia, current evidence does not support the use of prophylactic low-dose aspirin for the prevention of early on pregnancy loss, fetal growth restriction, stillbirth, or preterm birth.

Recommendations

The American College of Obstetricians and Gynecologists (ACOG) and the Lodge for Maternal–Fetal Medicine brand the following recommendations:

  • Depression-dose aspirin (81 mg/twenty-four hours) prophylaxis is recommended in women at high chance of preeclampsia and should be initiated between 12 weeks and 28 weeks of gestation (optimally before sixteen weeks) and connected daily until commitment.

  • Low-dose aspirin prophylaxis should be considered for women with more than 1 of several moderate adventure factors for preeclampsia.

  • Low-dose aspirin prophylaxis is not recommended solely for the indication of prior unexplained stillbirth, in the absence of take chances factors for preeclampsia.

  • Depression-dose aspirin prophylaxis is not recommended for prevention of fetal growth restriction, in the absence of risk factors for preeclampsia.

  • Low-dose aspirin prophylaxis is not recommended for the prevention of spontaneous preterm nascency, in the absence of gamble factors for preeclampsia.

  • Low-dose aspirin prophylaxis is not recommended for the prevention of early pregnancy loss.

Introduction

Aspirin is a cyclooxygenase inhibitor with antiinflammatory and antiplatelet properties. Low-dose aspirin has been used during pregnancy most commonly to foreclose or filibuster the onset of preeclampsia. Other suggested indications for low-dose aspirin take included prevention of stillbirth, fetal growth restriction, preterm birth, and early pregnancy loss. Recent systematic reviews of depression-dose aspirin use during pregnancy have improved our understanding of the function of depression-dose aspirin in each of these clinical situations. Despite this, the use of low-dose aspirin in clinical obstetrics practice remains varied. The purpose of this certificate is to summarize the testify and provide current recommendations regarding the employ of low-dose aspirin in pregnancy. It should be noted that although systematic reviews and consensus statements take used different doses of depression-dose aspirin, this document volition consider only the depression-dose aspirin available in the United States (81 mg).

Background

In November 2013, ACOG issued the Hypertension in Pregnancy Task Strength Report recommending daily low-dose aspirin beginning in the late first trimester for women with a history of early-onset preeclampsia and preterm delivery at less than 34 0/seven weeks of gestation, or for women with more than than ane prior pregnancy complicated past preeclampsia i. The following year, the U.S. Preventive Services Task Strength (USPSTF) published a similar guideline, although the listing of indications for low-dose aspirin employ was more expansive Table ane 2. The USPSTF guideline likewise suggested that low-dose aspirin be considered in women with "several" moderate risk factors for preeclampsia Table 1.

Low-Dose Aspirin Use During Pregnancy

Other health care organizations also accept published guidelines for preeclampsia prevention using low-dose aspirin based on risk factors. Published in 2011, the World Health Organization guideline recommended that low-dose aspirin (75 mg/24-hour interval) be initiated before twenty weeks of gestation for women at loftier risk of preeclampsia; eg, women with a history of preeclampsia, diabetes, chronic hypertension, renal disease, autoimmune disease, and multiple gestations 3. The National Institute of Wellness and Intendance Excellence published a quality statement, Antenatal Assessment of Pre-eclampsia Risk, in July 2013 that asked health care providers to prescribe low-dose aspirin (75 mg/24-hour interval) to pregnant women at increased run a risk of preeclampsia at the offset prenatal visit, to exist taken daily from 12 weeks of gestation until birth 4. The caste of take chances of preeclampsia was based on the presence of one or more high-risk factors (hypertensive disease in previous pregnancy, chronic kidney disease autoimmune disease, type 1 or type 2 diabetes, and chronic hypertension) or more than one moderate-risk factor (first pregnancy, maternal age of 40 years or older, a body mass index greater than 35, family history of preeclampsia, and multiple pregnancy) 4.

Pathophysiology

Aspirin (acetylsalicylic acid) is a nonsteroidal antiinflammatory drug (NSAID) that works primarily through its inhibition of two cyclooxygenase isoenzymes (COX-1 and COX-two), which are necessary for prostaglandin biosynthesis. The COX-1 isoform is present in the vascular endothelium and regulates the production of prostacyclin and thromboxane A 2, prostaglandins with opposing regulatory furnishings on vascular homeostasis and platelet function. Prostacyclin is a potent vasodilator and inhibitor of platelet assemblage, whereas thromboxane A ii (TXA2) is a strong vasoconstrictor and promotes platelet aggregation. The COX-2 isoform is inducible and expressed almost exclusively following exposure to cytokines or other inflammatory mediators. The consequence of aspirin on COX-dependent prostaglandin synthesis is dose dependent. At lower dosages (sixty–150 mg/day) aspirin irreversibly acetylates COX-ane, resulting in decreased platelet synthesis of TXA2 without affecting vascular wall production of prostacyclin five half dozen. At college doses, aspirin inhibits both COX-1 and COX-two, effectively blocking all prostaglandin production.

Evidence suggesting that an imbalance in prostacyclin and TXA2 metabolism was involved in the development of preeclampsia prompted the initial studies of aspirin for preeclampsia prevention because of its preferential inhibition of TXA2 at lower doses 7 8. However, it is probable that preeclampsia is a result of poor placentation from a variety of causes, including ischemia, reperfusion, or dysfunctional maternal inflammatory response towards the trophoblast 1 ix. Whether low-dose aspirin improves early placental perfusion is unknown, and besides, the precise mechanism by which low-dose aspirin prevents preeclampsia in some women is also uncertain ten 11.

Risks of Aspirin Use in Pregnancy

Maternal Risks

The bulk of systematic reviews of randomized controlled trials (RCTs) have found no increment in hemorrhagic complications associated with low-dose aspirin during pregnancy 12 13 xiv. A USPSTF report on depression-dose aspirin for prevention of preeclampsia identified no increased adventure of placental abruption (11 trials [23,332 women]; relative risk [RR], one.17; CI, 0.93–one.48), postpartum hemorrhage (nine trials [22,760 participants]; RR, i.02; CI, 0.96–one.09), or mean claret loss (five trials, [ii,478 women]; RR not reported) 14. Long-term daily aspirin use in non-pregnant adults (less than 300 mg/day for more than than 5 years) has been associated with an increased adventure of major gastrointestinal and cognitive bleeding episodes 15. In one RCT of low-dose aspirin during pregnancy for the prevention of preeclampsia, transfusion risk was slightly greater in treated patients, (4.0% versus 3.2%) sixteen.

Fetal Risks

Several systematic reviews of trials using low-dose aspirin for prevention of preeclampsia have shown no increased hazard of built anomalies 12 thirteen 14. Moreover, a recent RCT of 1,228 women, 615 of whom received depression-dose aspirin start before pregnancy and continuing throughout pregnancy, found no increased risk of adverse fetal or neonatal furnishings associated with depression-dose aspirin exposure 17. The number of built malformations also was non institute to be increased among a accomplice of nearly 15,000 women who reported aspirin apply during the first trimester xviii. Still, concern has been raised about a possible association between aspirin employ during pregnancy and gastroschisis 19 20 21. A meta-analysis that included 5 case–control studies suggested that a history of aspirin use was twice equally common in women with infants with gastroschisis compared with matched controls without gastroschisis 22. However, these data should be interpreted with extreme circumspection. In this meta-analysis, the dose of aspirin was not indicated (thus information technology is non clear whether this applies to the use of low-dose aspirin), the study evaluated women using aspirin in the kickoff trimester only and is subject to remember bias, and there were a number of variables not controlled, including apply of other licit and illicit drugs in these trials.

The apply of depression-dose aspirin (60–150 mg) in the third trimester has non been associated with ductal closure 23 24. Older animal studies suggested a relationship between in utero exposure to NSAIDs in full general and premature closure of the ductus arteriosus resulting in persistent pulmonary hypertension in the neonate 25. However, in contrast to this and other studies that did not differentiate blazon of dose of NSAID exposure, no increase in perinatal deaths from persistent pulmonary hypertension in the neonate has been reported among more than 30,000 women treated in RCTs involving the study of low-dose aspirin versus placebo for effect on a variety of outcomes 12 14 26.

The near recent Cochrane meta-analysis did not find an increased risk of neonatal intracranial hemorrhage (10 trials [26,184 infants]) or other neonatal hemorrhagic complications (eight trials [27,032 infants]) associated with maternal ingestion of low-dose aspirin during the tertiary trimester 12. Analysis of pooled data in the USPSTF systematic review was likewise reassuring, with no increment in intracerebral hemorrhage associated with low-dose aspirin use during pregnancy (10 RCTs [22,158 women]; RR, 0.84; CI, 0.61–1.16) xiv.

Contraindications to Aspirin Use During Pregnancy

At that place are few accented contraindications to aspirin therapy 27. Patients with a history of aspirin allergy (eg, urticaria) or hypersensitivity to other salicylates are at risk of anaphylaxis and should not receive depression-dose aspirin. Considering of meaning cross-sensitivity between aspirin and other nonsteroidal drugs, low-dose aspirin is besides contraindicated in patients with known hypersensitivity to NSAIDs. Exposure to depression-dose aspirin in patients with nasal polyps may result in life-threatening bronchoconstriction and should be avoided. The same is true in patients with asthma who have a history of aspirin-induced acute bronchospasm 27. Relative contraindications to depression-dose aspirin include a history of gastrointestinal haemorrhage, active peptic ulcer disease, other sources of gastrointestinal or genitourinary bleeding, and astringent hepatic dysfunction. Reye syndrome has been reported rarely (less than i%) in children younger than 18 years who are given aspirin while recovering from viral illnesses, particularly flu and chickenpox. The conclusion to continue depression-dose aspirin in the presence of obstetric bleeding or risk factors for obstetric bleeding should be considered on a instance-by-case basis.

Timing of Utilize During Pregnancy

With the exception of studies of low-dose aspirin for prevention of early pregnancy loss, the majority of trials using depression-dose aspirin during pregnancy have initiated treatment betwixt 12 weeks and 28 weeks of gestation. Some investigators take reported optimal results but when handling is started earlier 16 weeks 28 29 30 31. A recent meta-analysis of amass information from 45 randomized trials reported simply a pocket-size reduction in preeclampsia when low-dose aspirin was started after xvi weeks (RR, 0.81; CI, 0.66–0.99) merely significant reductions in severe preeclampsia (RR, 0.47; CI, 0.26–0.83) and fetal growth restriction (RR, 0.56; CI, 0.44–0.seventy) were demonstrated when depression-dose aspirin was started before 16 weeks 31. In another meta-assay, which included data from the contempo Combined Multimarker Screening and Randomized Patient Handling with Aspirin for Evidence-Based Preeclampsia Prevention trial, the authors reported a reduction in preterm preeclampsia just in the subgroup of patients in which aspirin was initiated before xvi weeks of gestation at a daily dose of 100 mg or more than (RR, 0.33; 95% CI, 0.19–0.57) xxx. In contrast, another study pooled individual information from 31 high-quality randomized trials and found that the beneficial effects of low-dose aspirin were consistent, whether treatment was started earlier or after 16 weeks of gestation 32.

At that place is no apparent benefit to stopping low-dose aspirin before delivery. Study protocols specific to pregnancy accept varied, with some discontinuing depression-dose aspirin at 36 weeks of gestation and others continuing low-dose aspirin until delivery 14 33 34 35. Discontinuation timing has not been related to excessive maternal or fetal bleeding. Likewise, depression-dose aspirin use in the absenteeism of other anticoagulants is not a contraindication to neuraxial blockade 36. Some patients present to care in the first trimester on low-dose aspirin. Whether first-trimester exposure is associated with adverse fetal effects or maternal benefit is non known.

Indications for Low-Dose Aspirin During Pregnancy

Prevention of Preeclampsia

The hypothesis that preeclampsia might be associated with vascular disturbances and coagulation defects resulting from an imbalance in prostacyclin and TXA2 led to the initial studies of aspirin for preeclampsia prevention. The results of several modest trials suggested that low-dose aspirin may exist beneficial for women at high take chances of preeclampsia 37 eight. However, until recently, this finding was non confirmed in larger RCTs 16 33 38, including a multicenter trial sponsored by the Eunice Kennedy Shriver National Found of Child Health and Human Development, which included more than 5,000 women 33. The 2017 Aspirin for Bear witness-Based Preeclampsia Prevention trial randomized one,776 women at loftier take a chance of preeclampsia based on a get-go-trimester screening algorithm to 150-mg aspirin or placebo 39. The authors establish a meaning subtract in the charge per unit of preterm preeclampsia (iv.3% versus 1.half dozen%; odds ratio, 0.38; 95% CI, 0.xx–0.74). Although the 150-mg dose was used in this study, there are no available studies comparing lx–80 mg versus 150 mg. Further, the screening algorithm used includes first-trimester serum markers, including placental growth factor and pregnancy-associated plasma protein-A, as well as uterine artery dopplers, which limits the generalizability to a U.S. population. Therefore, a higher dose or doubling of the available 81-mg dose cannot be recommended at this fourth dimension.

A meta-analysis pooling individual patient data from 31 RCTs showed a modest event of depression-dose aspirin prophylaxis on prevention of preeclampsia in groups of women with various adventure profiles (RR, 0.90; 95% CI, 0.84–0.97) 13. A subsequent Cochrane review, which pooled amass data from 59 trials, reported a 17% relative reduction in preeclampsia with low-dose aspirin use 12. All the same, this large risk reduction may reverberate publication bias (a small, early on positive trial is more probable to be published) or chance findings because the largest trials in the analysis showed no significant protective effect.

The 2014 USPSTF guideline on low-dose aspirin for prevention of morbidity and bloodshed from preeclampsia is based on the findings of their systematic review, which pooled data from 15 high-quality RCTs, 13 of which reported preeclampsia incidence among women considered at highest adventure of disease Tabular array i 2. A 24% reduction in preeclampsia (RR, 0.76; CI, 0.62–0.95) with depression-dose aspirin prophylaxis (60–150 mg/day) was demonstrated xiv. Still, the authors suggested this dramatic reduction in relative take chances might be closer to 10% considering of "modest study effects" of most of the included trials. Depending on baseline preeclampsia risk, the relative run a risk reduction with low-dose aspirin was associated with a minor decrease in an absolute hazard reduction of 2–5%.

Based on the findings from the USPSTF and others, low-dose aspirin prophylaxis (81 mg/day) later 12 weeks of gestation modestly reduces the risk of preeclampsia in women at increased gamble, without resulting in adverse fetal effects, increased maternal bleeding, or placental abruption. The recommendation to requite low-dose aspirin prophylaxis to high-risk women is based on the number needed to care for in individual risk groups, which in turn is based on disease prevalence and handling effect. In low-run a risk groups (disease prevalence of two%), the number needed to care for is approximately 500, compared with a number needed to treat of 50 women in a high-risk group with a illness prevalence of 20%. The USPSTF guideline recommends giving low-dose aspirin after 12 weeks of gestation to women with an absolute risk of preeclampsia of at least viii%, the everyman incidence of preeclampsia in control groups of studies included in their review 2. Based on celebrated and demographic risk factors, the USPSTF guideline recommends that women with any of the high-risk factors for preeclampsia should receive low-dose aspirin prophylaxis. Low-dose aspirin prophylaxis should exist considered in women with more than than one of several moderate gamble factors for preeclampsia Table one.

The American College of Obstetricians and Gynecologists and the Lodge for Maternal-Fetal Medicine support the USPSTF guideline criteria for prevention of preeclampsia. Depression-dose aspirin (81 mg/day) prophylaxis is recommended in women at high risk of preeclampsia and should exist initiated betwixt 12 weeks and 28 weeks of gestation (optimally before 16 weeks) and continued daily until delivery. Women who were receiving medically-indicated low-dose aspirin for other established medical indications before 12–28 weeks may continue with low-dose aspirin treatment.

Insufficient Evidence for Depression-Dose Aspirin

Stillbirth

Low-dose aspirin prophylaxis is non recommended for women with a history of stillbirth in the absence of take a chance factors for preeclampsia. Stillbirth and preeclampsia share many of the same risk factors, and when stillbirth is related to placental dysfunction, the underlying mechanisms are also likely like. Few studies have focused solely on the effect of low-dose aspirin prophylaxis on stillbirth. In 1 early nonrandomized trial, investigators reported a nearly twofold increase in live births when low-dose aspirin was given to women with at least one prior pregnancy loss at more than 13 weeks of gestation and a negative event on antiphospholipid antibiotic testing xl. Findings were like in a retrospective cohort study of 230 women with prior fetal loss at more than 10 weeks of gestation 41. Notwithstanding, the results of prospectively collected stillbirth data from RCTs and meta-analyses designed to study the use of low-dose aspirin for preeclampsia prevention are inconclusive 12 13 14. Until additional supportive evidence becomes available, low-dose aspirin prophylaxis is not recommended solely for the indication of prior unexplained stillbirth in the absence of adventure factors for preeclampsia.

Fetal Growth Restriction

Low-dose aspirin prophylaxis for prevention of recurrent fetal growth brake is similarly not currently recommended in women without other risk factors for preeclampsia considering of insufficient evidence in women with an isolated history of fetal growth restriction. However, in women at take chances of preeclampsia, prophylaxis with low-dose aspirin (especially when initiated less than 16 weeks of gestation) may reduce the risk of fetal growth restriction. Abnormal placentation resulting in poor placental perfusion (ie, placental insufficiency) is the most common pathology associated with fetal growth restriction 42. Some investigators have suggested that low-dose aspirin, initiated early in the starting time trimester, may prevent fetal growth restriction through its inhibitory action on platelet assemblage and comeback in placental development 43 44. 1 report first reported that low-dose aspirin, in combination with dipyridamole, significantly reduced the incidence of recurrent fetal growth restriction 45. Although this outcome was confirmed in a subsequent meta-analysis, the written report did not identify which women were well-nigh probable to do good from low-dose aspirin 46. At that place are currently no well-powered RCTs evaluating the role of low-dose aspirin in the prevention of recurrent fetal growth brake in otherwise low-risk women. Systematic reviews of depression-dose aspirin when used in the setting of preeclampsia prevention take consistently reported a 10–20% reduction in fetal growth restriction or infants who were modest for gestational age 12 13 xiv 29 xxx 31 32. Bear witness equally to whether starting low-dose aspirin before 16 weeks of gestation influences the caste to which low-dose aspirin is beneficial in reducing fetal growth restriction is inconclusive, though some meta-analyses have suggested improved do good with earlier initiation 29 30 31 32. Currently, because the majority of evidence supporting a reduction of fetal growth restriction from low-dose aspirin prophylaxis comes from studies of women who were also at chance of preeclampsia—non with histories of fetal growth restriction alone—at that place is insufficient evidence to support the utilise of depression-dose aspirin for fetal growth restriction prophylaxis in the absence of other adventure factors for preeclampsia.

Preterm Birth

The effect of depression-dose aspirin on preterm nascence as a primary result remains understudied. However, until bear witness from high-quality studies directed towards prevention of spontaneous preterm birth become bachelor, low-dose aspirin prophylaxis for prevention of spontaneous preterm birth, in the absence of hazard factors for preeclampsia, is not recommended.

Aspirin has been shown to decrease uterine contractility by inhibiting COX-dependent prostaglandin synthesis 47. Loftier doses of aspirin take been studied to treat preterm labor, but the irreversible binding to COX-2 and adverse maternal and fetal furnishings of high-dose aspirin prohibit its apply in the clinical setting. Low-dose aspirin has been reported to reduce preterm birth (at less than 37 weeks of gestation) in 8–14% of women at risk of preeclampsia 12 13 fourteen 32. However, whether this reflects a reduction in medically indicated or spontaneous preterm births is non clear in about studies. A recent systematic review and meta-assay 48 analyzed individual patient data from 17 trials of preeclampsia prevention (28,797 participants) that supplied sufficient particular regarding whether delivery was spontaneous or medically indicated. In that study, treatment with low-dose aspirin resulted in a 7% reduction in the risk of spontaneous preterm birth at fewer than 37 weeks (RR, 0.93; 95% CI, 0.86–0.996) and a 14% reduction in spontaneous preterm birth at fewer than 34 weeks (RR, 0.86; 95% CI, 0.76–0.99) compared with controls. Spontaneous preterm birth at fewer than 28 weeks was reduced past 19%, but the divergence was not statistically significant (RR, 0.81; 95% CI, 0.59–i.1) 48. Another written report using data from a randomized controlled trial of depression-dose aspirin versus placebo given to women with a history of pregnancy loss reported that low-dose aspirin, started earlier pregnancy and continued through pregnancy, was non associated with a reduction in overall preterm births (RR, 0.72; 95% CI, 0.42–one.23), spontaneous preterm birth (RR, 0.51; 95% CI, 0.19–ane.34), or medically indicated preterm nativity (RR, 0.89; 95% CI, 0.44–1.80) 49.

Indications for Which At that place Is No Do good for Low-Dose Aspirin

Early on Pregnancy Loss

The combination of low-dose aspirin and unfractionated or depression-molecular-weight heparin has been shown to reduce the risk of early pregnancy loss in women with antiphospholipid syndrome l. However, low-dose aspirin has not been shown to prevent unexplained early pregnancy loss in women who do not have antiphospholipid syndrome. Pooling data from two trials (256 participants), i study reported no increase in live births amidst women treated with depression-dose aspirin compared with placebo (RR: 0.94, CI, 0.80–1.eleven) 51. A 2014 written report too reported no difference in live births when 1,078 women with one or two prior pregnancy losses were given low-dose aspirin or placebo before pregnancy (58% versus 53%, P=.0984). Pregnancy loss occurred in xiii% of 535 women given low-dose aspirin compared with 12% of 543 women in the placebo group ( P=.7812) 35. Based on the available prove, the use of low-dose aspirin prophylaxis is not recommended for the prevention of early on pregnancy loss.

Conclusions

Daily low-dose aspirin utilize in pregnancy is considered safe and is associated with a low likelihood of serious maternal, or fetal complications, or both, related to use. The American College of Obstetricians and Gynecologists and the Guild for Maternal-Fetal Medicine support the USPSTF guideline criteria for prevention of preeclampsia. Low-dose aspirin (81 mg/d) prophylaxis is recommended in women at loftier risk of preeclampsia and should be initiated between 12 weeks and 28 weeks of gestation (optimally earlier 16 weeks) and continued daily until delivery. Low-dose aspirin prophylaxis should exist considered for women with more than one of several moderate gamble factors for preeclampsia. Women at risk of preeclampsia are defined based on the presence of one or more loftier-take a chance factors (history of preeclampsia, multifetal gestation, renal disease, autoimmune disease, type 1 or type ii diabetes, and chronic hypertension) or more than than i moderate-risk factor (first pregnancy, maternal age of 35 years or older, a torso mass alphabetize greater than 30, family history of preeclampsia, sociodemographic characteristics, and personal history factors) Table 1. In the absence of high-take chances factors for preeclampsia, current prove does not support the utilise of prophylactic depression-dose aspirin for the prevention of early pregnancy loss, fetal growth restriction, stillbirth, or preterm nascency.

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This information is designed as an educational resource to assist clinicians in providing obstetric and gynecologic care, and apply of this information is voluntary. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. It is not intended to substitute for the independent professional judgment of the treating clinician. Variations in practise may be warranted when, in the reasonable judgment of the treating clinician, such course of activeness is indicated by the condition of the patient, limitations of available resource, or advances in noesis or engineering science. The American College of Obstetricians and Gynecologists reviews its publications regularly; withal, its publications may not reverberate the most recent evidence. Any updates to this document can exist found on www.acog.org or by calling the ACOG Resources Middle.

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Published online on June 25, 2018.

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Low-dose aspirin use during pregnancy. ACOG Committee Opinion No. 743. American College of Obstetricians and Gynecologists. Obstet Gynecol 2018;132:e44–52.

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Source: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/07/low-dose-aspirin-use-during-pregnancy

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