| Objective:To compare and analyze the preventive effect and the time of application of low-dose aspirin on preeclampsia,and to provide assistance for prevention and control of preeclampsia and improvement of maternal and neonatal outcomes.Methods:In this study,from January 2018 to December 2018,180 women at high risk of preeclampsia who were registered and participated in pregnancy health care were screened out in the obstetric clinic of Qingzhou Maternal and Child Health Hospital.They were randomly divided into study group(group A,group B)and blank control group,with60 cases in each group.Study groups A and B were supplemented with aspirin based on the control group.Group A took aspirin 75mg(3 tablets)daily from 12 weeks of gestation;Group B was given 75 mg aspirin(3 tablets)daily starting at 16 weeks of gestation.Group A and group B stopped taking medicine at 28 weeks of gestation.Based on lowering blood pressure without affecting the blood supply to the kidney and placenta,for patients with elevated blood pressure during pregnancy,according to different conditions,it is recommended to take the antihypertensive drug labelol hydrochloride,the blood pressure was controlled within the target value of 130～155/80～105mm Hg(for patients with concurrent organ dysfunction,the blood pressure was controlled within the range of130～139/80～89mm Hg).The incidence of preeclampsia,placental abort,postpartum hemorrhage and other pregnancy outcomes and adverse reactions,as well as the birth weight,fetal growth restriction(FGR)and neonatal asphyxia were compared among the three groups.Serum s FLT-1 level was detected before and after treatment,and s FLT-1expression level was detected in placenta tissue after treatment.To analyze the clinical effect and mechanism of low-dose aspirin in the prevention of preeclampsia at different gestational ages.Results :(1)The incidence of preeclampsia in control group was 26.67%,which was significantly higher than that in study group A(8.33%)and study group B(11.67%)(P<0.05).The incidence of preeclampsia in study group A was slightly lower than that in study group B(P >0.05).There was no placental abruption in the study group,and the incidence of placental abruption in the control group was 6.67%,which was significantly higher than that in the study group A and B(P<0.05).The incidence of postpartum hemorrhage in the control group was 11.67%,which was significantly higher than that in the study group A and B(1.67%,P<0.05).There was no significant difference between the study group A and B(P>0.05).(2)The mean gestational age of the control group was(36.25±2.79)weeks,which was significantly lower than that of the study group A(38.78±2.49)weeks and that of the study group B(38.34±2.64)weeks(P<0.05).The A group was slightly higher than the B group and the difference was not statistically significant(P>0.05).The mean weight of neonates in control group was(2.60±0.81)kg,which was significantly lower than(2.86±0.64)kg in study group A and(2.80±0.79)kg in study group B(P<0.05).Apgar score of neonates in control group was lower than that in study group A and study group B,but there was no significant difference between groups(P>0.05).The incidence of fetal growth restriction in the control group was 11.67%,which was significantly higher than that in the study group A and B(1.67%,P<0.05).There was no significant difference between the study group A and B(P >0.05).The incidence of premature infants in control group was 36.67%,which was significantly higher than that in study group A(18.33%)and study group B(20.00%)(P<0.05),study group B was slightly higher than that in study group A(P >0.05).The incidence of neonatal asphyxia in the control group was 13.33%,which was slightly higher than that in the study group A(6.67%)and the study group B(8.33%).The incidence of neonatal asphyxia in the study group B was slightly higher than that in the study group A(P>0.05),but the difference between the two groups was not statistically significant(P> 0.05).(3)There was no significant difference in serum s FLT-1 expression among the three groups before treatment(P>0.05).After treatment,the serum s FLT-1 level of study group A and study group B was significantly decreased compared with before treatment(P<0.05),and that of control group was decreased compared with before treatment,but there was no statistical significance(P>0.05).Comparison between groups showed that the index level of study group A and study group B after treatment was significantly lower than that of control group(P<0.05),and there was no significant difference in the expression level of s FLT-1 between study group A and study group B after treatment(P>0.05).The expression level of s FLT-1 protein in placental tissue of control group was(0.16±0.01),that of study group A and study group B was(0.15±0.01)and(0.15±0.02),respectively.The index level of study group A and study group B was significantly lower than that of control group(P<0.05).There was no significant difference between study group A and study group B(P>0.05).Conclusion:(1)Low-dose aspirin has a significant effect on the prevention of preeclampsia.Oral aspirin at 12 and 16 weeks of gestation can effectively prevent and control the occurrence of preeclampsia.(2)Taking low-dose aspirin during pregnancy can also help prevent placental abruption and postpartum bleeding,and improve the pregnancy outcome and complications.(3)Taking low-dose aspirin in advance can also improve the neonatal outcome,gestational age,birth weight,and preterm delivery situation can be improved significantly,the effect has no obvious difference from 12 weeks or 16 weeks of pregnancy to start taking aspirin.(4)Low dose aspirin can reduce serum SFLT-1 level and placental SFLT-1 protein expression level in patients,so as to play a role in the prevention and treatment of preeclampsia. |
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