A small daily dose of upto 75 mg of aspirin can significantly reduce hypertension-related complications like pre-eclampsia, recommends the National Institute for Health and Clinical Excellence (NICE).
Hypertension or high blood pressure is a leading cause of maternal deaths. According toe the new NICE recommendation pregnant with hypertension should take aspirin 75mg daily from 12 weeks gestation until the birth of the baby.
“Hypertension, or high blood pressure, can be fairly common and can develop at any time during pregnancy. If not properly managed, it can cause serious health problems. That’s why it’s important that women who are pregnant or planning a pregnancy and who have either been diagnosed or identified as being at risk of developing a form of hypertension, receive a consistent, high standard of antenatal and postnatal care to prevent problems occurring,” stated Dr Fergus Macbeth, Director of the Centre for Clinical Practice at NICE.
NICE also recommends obstetricians, GPs, midwives and other healthcare professionals to inform women with hypertension who are planning a pregnancy that angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), which can be used to control hypertension in non-pregnant women, can increase the risk of congenital abnormalities if taken during pregnancy and discuss more suitable forms of antihypertensive treatment.
Pregnant women with hypertension should be offered with hypertension or pre-eclampsia a package of care including admission to hospital, treatment, measurement of blood pressure, testing for protein in their urine and blood tests.
NICE recommends ultrasounds to assess fetal growth, amniotic fluid volume and Doppler ultrasound to measure blood flow in the umbilical artery at different stages of pregnancy and according to the seriousness of hypertension in the expectant mother.
Docs can offer birth to women with pre-eclampsia after 34 weeks, but only once their blood pressure is under control, after discussions with specialists. If needed, a course of antenatal steroids has been given to the woman to help mature the baby’s lungs before birth.
NICE also calls for advising women who have had pre-eclampsia to keep or achieve a healthy BMI before their next pregnancy.
The off-licence recommendation is made for those considered at high risk due to having experienced hypertension in a previous pregnancy or having chronic kidney disease, type 1 or 2 diabetes, chronic hypertension or an autoimmune disease such as systemic lupus erythematosis or antiphospholipid syndrome.
NICE guideline also wants pregnant women restrict their salt consumption. Dietary supplements such as magnesium or antioxidants especially vitamins C and E will not help prevent hypertension during pregnancy, it alerts.