Hi everyone,
Earleir this week I was asked to review some evidence published by NICE for my comments,
This was my reply....
A low dose of aspirin taken during pregnancy can help prevent high blood pressure, according to advice from the National Institute for Health and Clinical Excellence (the independent body responsible for providing national health guidance).
High blood pressure in pregnancy increases the likelihood of having a baby prematurely, a stillbirth, or a smaller than average baby, and mothers face an increased risk of developing high blood pressure later in life.
The new guidance recommends that 75mg aspirin is offered daily to women who are at high risk of developing high blood pressure in pregnancy. This includes those with chronic kidney disease, autoimmune disease (such as lupus), diabetes, chronic high blood pressure, or those who have had high blood pressure-related illness during a previous pregnancy.
Daily aspirin will also be offered to those with more than one moderate risk factor, including a first or multiple pregnancy, an interval between pregnancies of over 10 years, those aged 40 or over, women have a BMI or over 35kg/m², or a family history of pre-eclampsia.
Lynda Mulhair, Consultant Midwife at Guy’s and St Thomas’ NHS Foundation Trust and guideline developer, said that while tests for signs of hypertension were already regulatory there had been “a lack of guidance on what to do if a condition like this is diagnosed”.
“This guideline seeks to fill that gap so that women who subsequently develop such a condition receive the best possible care from the NHS,” said Mulhair.
Liz says: Doctors have known for many years that the blood clotting systems of some women affected by hypertension in pregnancy tend to be overactive, making the blood more liable to clot. The specialised clotting cells known as platelets, which circulate in the blood in vast numbers, are particularly affected. The logic of using aspirin is that, if taken in small daily doses, it is known to have a calming effect on platelet activity, so inhibiting the clotting tendency to some extent.
The guidance also recommends advice is given that cutting down on salt, and taking magnesium, or Vitamin C or E supplements will not help prevent high blood pressure in pregnancy.
“Whilst this information gives women & health professionals much clearer guidance when treating a pregnant woman with high blood pressure, low-dose aspirin in pregnancy should be taken only under the strict supervision of your doctor as you will need to be monitored more closely.”