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YOUR HEALTH: Pregnant women and low aspirin doses

Experts have outlined a simple preventive step for high-risk women, but are moms following doctor's orders?

PITTSBURGH — Almost a decade ago, doctors began recommending women with a high risk for preeclampsia take a regular baby aspirin to help prevent the condition.

But a new study finds that information may not be getting out.

That's a problem.

Preeclampsia is a condition where women develop high blood pressure, have swelling in the legs and protein in the urine. 

It develops in one-in-25 pregnant women in the United States and is a factor in 15% of all premature births. 

"So, it's not something that ends with delivery, but has ongoing implications for cardiovascular health," said Tamar Krishnmurti, a University of Pittsburgh School of Medicine researcher.

Women with high blood pressure or kidney disease before pregnancy may be at high risk for developing preeclampsia during pregnancy. 

The U.S. Preventive Services Task Force has recommended women at high risk take one of these daily.

"Actually, if you take a low dose baby aspirin, you can decrease the risk of developing preeclampsia because that aspirin is an anticoagulant," Krishnmurti said.

But is that information getting through? 

Researchers used data from a smartphone app called "My Healthy Pregnancy" to determine if pregnant women at high risk of preeclampsia were following recommendations.

"What we found, which was particularly interesting, was that about 37% of those patients who were prescribed aspirin, appropriately were not aware that they were being prescribed aspirin," Krishnmurti said.

The study also found that, of the pregnant women who knew they should take baby aspirin, less than half only 49% followed their doctor's advice. 

Krishnamurti and her colleagues say they're not sure why there is a problem with adherence.

Some women may hesitate to take any medication during pregnancy and others confuse safe drugs like baby aspirin with drugs that are not safe for pregnancy like ibuprofen.

"But in a low enough dose there is really no risks to the mother or fetus from taking it," Krishnamurti said. 

Tag researchers say a digital platform like My Healthy Pregnancy could help flag patients with preeclampsia risk factors and could prompt more detailed conversations between doctors and women at risk about the benefits of taking low dose aspirin.

Finding those mothers who are high risk

Doctors can diagnose preeclampsia by checking the mother's blood pressure.

Many people do not have any symptoms. 

For people who do feel symptoms, the first signs are high blood pressure, protein in the urine and retaining water. 

Other signs can include:

  • headaches
  • blurry vision or light sensitivity
  • dark spots appearing in your vision
  • right side abdominal pain
  • swelling in your hands and face (edema)
  • shortness of breath

In order to treat the condition it's important to share symptoms with your doctor. 

Severe preeclampsia symptoms are more noticeable. 

They include: hypertensive emergency (blood pressure is 160/110 mmhg or higher), decreased kidney or liver function, fluid in the lungs, low blood platelet levels (thrombocytopenia) and decreased urine production.

A solution already inside the body

Researchers at the Boston Children's hospital have discovered that a compound made naturally by the body may be able to stop preeclampsia before it starts. 

It's called the MEx therapy and it is purified MEx from MSCs isolated from human umbilical cords. 

After delivering MEx intravenously into the mother, the team saw evidence that they eventually migrated to cells in the uterus. 

This study was done in mice who have similar first trimester pregnancies to humans. 

So far, the study shows that MEx prevented maternal symptoms of preeclampsia and fetal growth restriction when given early.

If this story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Jim Mertens at jim.mertens@wqad.com or Marjorie Bekaert Thomas at mthomas@ivanhoe.com

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