Document Detail


Clinical and geographical variation in prophylactic and therapeutic treatments for pre-eclampsia in the UK.
MedLine Citation:
PMID:  20175876     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the clinical and geographical variation in the use of aspirin in women at high risk of pre-eclampsia, and in the use of antihypertensive drugs and magnesium sulphate in women with established pre-eclampsia. DESIGN: Analysis of vitamins in pre-eclampsia (VIP) trial database. SAMPLE: A total of 2399 women at increased risk of pre-eclampsia in 25 UK hospitals. METHODS: An analysis of a large prospectively validated database of high-risk women in the UK was undertaken to assess aspirin use across different risk groups and to evaluate the use of antihypertensives and magnesium sulphate in 370 women who developed pre-eclampsia. Logistic regression was employed to compare drug use between region and by recognised clinical indicators. MAIN OUTCOME MEASURES: Usage of aspirin, antihypertensive drugs and magnesium sulphate. RESULTS: Of the women with known risk factors at trial entry, 24% (569/2399) received low-dose aspirin. Aspirin usage varied widely between risk groups [from 5% (19/378) in women with multiple pregnancy to 94% (50/53) in women with antiphospholipid syndrome] and between geographical regions [from 8% (20/248) to 49% (95/193)]. Three hundred and seventy women developed pre-eclampsia, 52% (n = 193) of whom received new or additional antihypertensives after 20 weeks of gestation; 34% (77/224) with a maximum recorded systolic blood pressure of >OR=160 mmHg in the second half of pregnancy did not receive antihypertensive treatment; 17% (62/370) of women with pre-eclampsia received magnesium sulphate prophylactically. CONCLUSIONS: Prophylactic and treatment regimes for pre-eclampsia in the UK vary by region and risk group.
Authors:
L C Chappell; P Seed; S Enye; A L Briley; L Poston; A H Shennan
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-02-22
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  117     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-08     Completed Date:  2010-06-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  695-700     Citation Subset:  AIM; IM    
Affiliation:
Maternal and Fetal Research Unit, Division of Reproduction and Endocrinology, King's College London School of Biomedical and Health Sciences, London, UK. lucy.chappell@kcl.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Anticonvulsants / therapeutic use*
Antihypertensive Agents / therapeutic use*
Aspirin / therapeutic use*
Female
Great Britain
Humans
Magnesium Sulfate / therapeutic use*
Platelet Aggregation Inhibitors / therapeutic use*
Pre-Eclampsia / drug therapy*,  prevention & control
Pregnancy
Residence Characteristics
Risk Factors
Chemical
Reg. No./Substance:
0/Anticonvulsants; 0/Antihypertensive Agents; 0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 7487-88-9/Magnesium Sulfate

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