[Uterine velocimetry and vascular pregnancy pathologies prevented with low-dose aspirin]

Several trials have been published about the usefulness of early uterine Doppler waveform in the prediction of pre-eclampsia and intrauterine growth retardation in nulliparous or low risk patients. We reviewed 3 trials introducing aspirin therapy in patients selected by an early abnormal uterine Doppler waveform. In one trial, serum alpha fetoprotein above 2.5 median at 16 weeks was used as a first selection criterion. In two studies, the incidence of pre-eclampsia was significantly decreased in aspirin treated groups: McParland's trial (odds ratio: 0.08; 95% CI:0.01-0.63) and Campbell's preliminary report (odds ratio: 0.15; 95% CI:0.02-0.91). In contrast, the rate of intra-uterine growth retardation was found similar in aspirin and placebo treated patients. To clarify the usefulness of aspirin therapy in patients with early abnormal uterine Doppler in improving maternal and fetal outcome, other prospective large studies are needed.