pre-eclampsia and low dose aspirin

[LiegeAndLief]

I had pre-eclampsia in my first pg, starting about 29 weeks, ds born at 34 weeks. My consultant has recommended that I should take 75mg aspirin in a second pg, starting at 11+6. However, I've seen a lot of people on this board have been told to start taking it as soon as they found out they were pg. Would be really interested to hear other people's consultants' opinions - if anyone has links to any research which suggests when to start taking it, that would be really good too!

Hello LiegeAndLief
I was told to start aspirin as soon as I had a positive pregnancy test. My consultant felt that the risk of aspirin on a developing embryo is very small and that it's important that aspirin is taken as the placenta forms, as that is when it is likely to be most effective (as the two sets of blood vessels converge)~ and then to keep taking it for its blood thinning properties until 36 weeks. Basically they want you off it ideally for at least a week before giving birth so that you aren't at too high a risk of haemorrhage (sp) during childbirth.

I too have heard many different opinions of when to start the aspirin- some even start while TTCing, others not until 12 weeks. I think some consultants are concerned of the potential toxicity of aspirin to a developing embryo, with the highest risk being (like most things) during the first 12 weeks.

But where PE was very severe/rapidly developing they often recommend it earler as think the benefit of ensuring its effectiveness during placental formation outweighs the risks to the embryo (I had HELLP syndrome- DS delivered at 30wks).

I can't find specific research looking at when aspirin therapy is best started, I don't think such research has been done yet- but the research on benefits of aspirin is all done where it is started at or before 12 weeks.

I recommend possibly emailing a lady who knows a great deal about PE (and is a qualified medic too, and is very good at promptly answering queries)- take a look at the "Ask Liz" section on this forum: pesupport.friendhood.net/index.htm

You also might find out more from the US PE foundation: www.preeclampsia.org/forum/default.asp

When you decide to TTC no.2 I wish you the very best of luck~ it's great that you have already had a preconception meeting so know the score...

Thanks a lot Nika, you are a fountain of pre-eclampsia knowledge! Those links look great, will check them out when I have a bit more time. Yes pre-conception appt was very helpful. Am very confused over when to start the aspirin though... I guess ultimately I will just have to trust my consultant to know what is best for me and stop trying to work it all out for myself!

I think you've hit the nail on the head really- your consultant will know what's best for you- they have your history etc. and can weigh up the risks/benefits in your particular case better than we can ever know...As there are many other factors to consider too when rescribing aspirin. You have certainly done the right thing seeing an appropriately experienced consultant prior to conceiving- that puts you ahead of the game already and hopefully give you the very best chances of a successful PE-free pregnancy when the time comes.

Good luck!