Role of aspirin therapy in modulating uterine artery resistance and placental growth between first and second trimesters of pregnancy
Trilla, Cristina (Institut de Recerca Sant Pau)
Platero, Judit (Institut de Recerca Sant Pau)
Mora Brugués, Josefina (Institut de Recerca Sant Pau)
Nan, Madalina Nicoleta (Institut de Recerca Sant Pau)
Medina, Carmen (Institut de Recerca Sant Pau)
Alejos Abad, Obdulia (Institut de Recerca Sant Pau)
Parra Roca, Juan (Institut de Recerca Sant Pau)
Llurba, Elisa (Institut de Recerca Sant Pau)
Universitat Autònoma de Barcelona. Departament de Medicina

Data:	2025
Resum:	To evaluate the impact of low-dose aspirin (LDA) on placental size and uterine artery pulsatility index (UtA-PI) by analyzing longitudinal changes between the first and second trimesters in pregnancies at high risk for early-onset pre-eclampsia (PE). This was a prospective observational cohort study of 631 singleton pregnancies. Women at high risk of early-onset PE (delivery ≤ 33 + 6 weeks) were identified using maternal factors or a multivariate screening protocol and were prescribed LDA. Placental size was assessed using two- and three-dimensional ultrasonography, and UtA-PI was measured using transabdominal Doppler, with measurements obtained in the first and second trimesters. Differences in placental measurements and UtA-PI between high-risk women receiving LDA and low-risk untreated women were analyzed. Among the 631 participants, 53 (8. 4%) women were prescribed LDA for the prevention of early-onset PE. Placental size in the first trimester was significantly smaller in the LDA group compared with the untreated group, as exemplified by placental volume (mean ± SD, 68. 46 ± 25. 19 cm 3 vs 76. 31 ± 23. 63 cm 3 ; P = 0. 022), and this trend persisted into the second trimester. However, no significant differences in placental growth from the first to the second trimester were observed between the groups. UtA-PI was significantly higher in the LDA group in both trimesters, but a greater decrease in UtA-PI multiples of the median values between trimesters was noted in these women (mean ± SD, -14. 0 ± 0. 28% vs -4. 5 ± 0. 31%; P = 0. 021). Perinatal outcomes were similar between the groups, with the exception of a higher rate of Cesarean delivery in the LDA group (38. 5% vs 21. 1%; P = 0. 008). Women at high risk for early-onset PE have a smaller placenta and higher UtA-PI in the first and second trimesters. Treatment of high-risk women with LDA did not affect placental growth but was associated with a greater reduction in UtA-PI, suggesting a positive effect of LDA on placental perfusion. These findings provide insight into the mechanism of action of LDA in the prevention of PE. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	First trimester ; Low-dose aspirin ; Placental biometry ; Placental volume ; Pre-eclampsia ; Three-dimensional ultrasound ; Two-dimensional ultrasound ; uterine artery Doppler
Publicat a:	Ultrasound in obstetrics & gynecology, Vol. 66 (September 2025) , p. 641-648, ISSN 1469-0705

DOI: 10.1002/uog.70095
PMID: 40974599

8 p, 1.9 MB

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