Aspirin use in pregnancy
ALTHOUGH aspirin is available as an over-the-counter drug in Jamaica, many people are reluctant to use it because it is believed to cause or worsen bleeding associated with some diseases and conditions. For some pregnant women, though, aspirin may be the best option for them to have a successful pregnancy.
Consultant obstetrician-gynaecologist Dr Kimberly Martin says that daily low dose aspirin is not only considered safe during pregnancy, but is also helpful in treating some conditions.
“Low dose aspirin is used and recommended in the prevention and delay of preeclampsia in pregnancy,” she said.
Preeclampsia is a pregnancy complication marked by high blood pressure and signs of damage to another organ system, usually the liver and kidneys.
“In this case it is initiated ideally before 16 weeks of pregnancy and it reduces the risk of pre-term birth and slow foetal growth that may be associated with this condition,” Dr Martin said.
“Other conditions in which aspirin can be used include patients with autoimmune conditions in pregnancy and it may be considered for patients with a history of recurrent pregnancy losses (depending on the underlying cause).”
She assured women who might be put off by aspirin’s bad reputation that it will not harm them or their babies.
“With the use of aspirin, increased risk of bleeding may come to mind; however, systematic reviews of randomised trials have not demonstrated an increased risk of bleeding complications associated with low dose aspirin use in pregnancy,” she said.
“There is no evidence to support adverse effects on the developing foetus. Studies have demonstrated no increase in congenital anomalies when low dose aspirin is administered in the first trimester. Neither is there an increased risk of bleeding in newborns associated with the administration of low dose aspirin.”
She warned, however, that aspirin may not be right for everyone.
“It is not recommended in patients with a history of allergy or hypersensitivity to aspirin, or even hypersensitivity to other non steroidal anti-inflammatory medications (NSAIDs), as cross sensitivity can occur. Aspirin is also not recommended in patients with nasal polyps as it can cause constriction of the airways. It is to be used with caution in patients who are asthmatics as it may exacerbate bronchospasm. Relative caution has to be exercised in patients with a history of peptic ulcers or history of other gastrointestinal bleeding, liver dysfunction, and of course in our population, patients who are suspected of having or recovering from viral illnesses.”
She advised, too, that aspirin is not to be self-prescribed for the usual aches and pains of pregnancy.
“The use of aspirin is to be guided by your obstetrician for specific indications,” she cautioned. “If concerns arise please seek prompt medical advice that allows for your doctor to perform a comprehensive assessment in order to determine the need for medications and to make an appropriate recommendation for medications that are safe for you and your baby.”
Dr Kimberly Martin, BSc (Hons), MBBS, DM(OBGYN), FACOG, is a consultant obstetrician and gynaecologist at Woman’s World Medical Suites, 3 Murray Ave, Morant Bay, St Thomas, and Island Surgical Partners, Office 16-18 Tangerine Place, Kingston 10. Follow her on Instagram @drkmartinobgyn.
