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  • "qwerty" started this thread

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Wednesday, November 10th 2010, 11:11am

Low Dose Aspirin in Pregnancy...is it OK?

Hi Everyone,

I hope you don't mind me posting here - it has been a while since I have had tx and I have just found out that I am 5 weeks preg (natural BFP which is a miracle!)....

I have been prescribed low dose aspirin to try and prevent miscarriage and my doctor said that it can also help prevent growth restriction (my daughter had IUGR) and pre eclampsia. I am not a fan of taking anything in pregnancy and I have done some research and have read conflicting information. I am currently living in the UAE and it is not that I don't trust the doctor here, but I know that different countries do different things and would love to know if anyone else has been prescribed aspirin and how long you take it for.

Thanks all!

x

ICSI March 2008 BFP, then early m/c, Natural BFP May 2008, m/c at 6 weeks
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Wednesday, November 10th 2010, 11:15am

Hi, congratulations on your pregnancy...how exciting. I was prescribed Aspirin, 75mg daily and advised to take up to 32 weeks. I know what you mean though and I also hate taking it.

Eeyore

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Wednesday, November 10th 2010, 11:34am

Hello stranger, lovely to see you!

As you say, there is a great deal of conflicting advice

Aspirin Asprin

taking baby aspirin?

stopping aspirin at 34 weeks

A few threads here may help

x

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Wednesday, November 10th 2010, 12:49pm

Hey hon,

I too had to take it until 34 weeks xxx


nn
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Wednesday, November 10th 2010, 12:52pm

HI qwerty, long time no see! Many congratulations on your news x

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Wednesday, November 10th 2010, 1:40pm

hi hon

can you ask your doctor to give you clexane rather than aspirin. they are both blood thinners so should do the same thing, but aspirin crosses the placenta so it would be better to have clexane.

I took aspirin on my last IVF cycle but I only took it until Egg collection, after that I went onto clexane as it does not cross the placenta and so does not affect the baby's blood.

Also please see the attached research links which I am going to post as a new thread too:

painkillers in pregnancy
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Wednesday, November 10th 2010, 1:49pm

see also my thread on painkillers where the NHS conclusion on the new research is:

"For women wondering what to take away from these results, the advice is that it is safest not to take these drugs during pregnancy. Specifically, the advice is to avoid ibuprofen and aspirin during pregnancy but there is no evidence that occasional use of paracetamol is harmful. "
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Wednesday, November 10th 2010, 1:59pm

Sorry to say clexane and aspirin don't do the same thing. They are both used to prevent clot formation but without getting too technical they work in very different ways. Aspirin inhibits platelet aggregation so stops the clot from forming. Clexane activates antithrombin III and as a result inhibits coagulation factors Xa and IIa which are part of the coagulation cascade. They are prescribed for very different things and you would never swap a patient from one to the other, they aren't interchangeable. This may seem like a minor distinction but it isn't. They are usually given together precisely because they work in different ways.
The truth is that there is no clear evidence to suggest that aspirin or clexane reduce early miscarriage or improve IVF success rates, unless the patient involved has a specific clotting problem diagnosed on blood test.
However there have been some studies showing that aspirin and clexane reduce 2nd trimester losses in women who have had previous late miscarriage (ie second trimester and beyond). The most interesting thing in that study though was that actually the second trimester m/c rate increased when aspirin and clexane were given, in patients who had previously suffered first trimester losses. This may seem on the face of it like a negative effect of the drugs. However the thinking is that actually for these patients the drugs were preventing first trimester loss, though sadly they went on to miscarry later. This was the latest study done, and as such represents the first clear evidence that aspirin and clexane may help to prevent early miscarriage.

The other thing to bear in mind is that most of the studies done look at the effects of aspirin and clexane together, not separately.

I would not worry about aspirin crossing the placenta. Lots of things do and it doesn't mean they do harm. There have been numerous studies showing that low dose aspirin is safe in early pregnancy, providing you are monitored by a doctor while you take it. It may be worth asking about clexane as well though, but they aren't really either or drugs. As I say they both prevent clotting, but it doesn't mean that they do the same thing.

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Wednesday, November 10th 2010, 2:04pm

ruthie I am beginning to wonder if your aim in life is to contradict me! lol!!!

I dont agree about aspirin I am afraid. There is a lot of evidence that it is best to stay away from it if you can in pregnancy and doctors have historically handed it out like smarties as a 'catchall'. This is not the case. Its still a drug and one I would think carefully about taking. The new train of thought is that its not so simple as to just take it and it won't do any harm.

You will see also on the NHS site like I have posted that they are now saying it should NOT be taken.
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Wednesday, November 10th 2010, 2:26pm

So as not to worry or panic anyone taking aspirin, there is of course a difference between normal (150mg) and low-dose (75mg) aspirin.

The NHS site does indeed say that aspirin should not be taken but it also states that

Quoted


Low-dose aspirin (75mg) may be taken if you are pregnant or breastfeeding, but only on the recommendation of your GP. Aspirin at doses higher than 150mg per day is not recommended during pregnancy or breastfeeding.


http://www.nhs.uk/Conditions/Anti-platel…iderations.aspx

ruthie

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Wednesday, November 10th 2010, 2:37pm

Not wanting to contradict, it's just differing opinions.

I do think it's important to differentiate between normal aspirin usage or usage of any non-steroidal anti inflammatories, and taking 75mg of aspirin daily.
The NHS guidelines are to give no NSAIDs in early pregnancy, and they've been that for years. This is primarily because of their anti coagulant properties and the worry is that they might increase the risk of bleeding. Obviously in the case of trying to prevent m/c the aspirin and the clexane are given for precisely the same reason that aspirin is considered to be contraindicated.

What the NHS want to prevent when they give this advice, is people taking ibuprofen or aspirin at the normal higher dose for a headache, when paracetamol will work just as well. Low dose aspirin is genuinely different.

Ultimately you have 2 approaches. You can either go with a gut reaction, and the bottom line is that if you feel uncomfortable taking it then you have to take that into account.
The other is to read every piece of research available and question your doctors over and over again. That's been my approach over the last few years and it's not an easy one, as a lot of the info is conflicting. I was comfortable with aspirin as all the studies show that at 75mg once a day the risks are very low. There isn't a clear benefit re miscarriage yet (except for Hughes syndrome), I think more studies need to be done, but as you say there is a clear benefit re both preventing pre eclampsia, also growth retardation and premature delivery.

On balance I would take it but you do need to feel comfy with your decision. When all is said and done, you are the one taking the meds and going through all of this.

Having said all that massive congratulations on a lovely natural BFP! (I realised I forgot to say that earlier!)

xxx

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Wednesday, November 10th 2010, 3:39pm

Yes, agreed - there is a difference between someone taking normal dose aspirin for pain relief whilst pregnant and having low-dose aspirin prescribed as part of a clinically defined protocol. Mine was the latter and I was happy to take it under my consultant's advice and supervision.

And of course, most importantly - Congratulations! :D xxx


nn
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  • "qwerty" started this thread

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Wednesday, November 10th 2010, 4:27pm

Hi Eeyore and Bubble! Sorry haven't been around much, who knew having a baby was so much work?! :innocent: And now that we are living in the desert, well it presents a few other challenges and there never seems to be enough time!

Thanks ladies for your responses. I must admit, I am still a bit confused. There does seem to be a fair bit on low dose aspirin as being ok. It is a tough one as you want to do anything possible not to miscarry, but you also don't want to do anything to hurt the baby.

From what I gather, I was prescribed the aspirin mainly because of previous miscarriages as well as the fact that my daughter was born 4 weeks early due to her not growing. I am also taking progesterone.

Today was the first time I met him and he is a specialist and seemed to be very knowledgeable and asked a lot of questions and basically it seemed like he knew what he was talking about. I will be regularly monitored and there is a scan at least every month for the first few months and thn every 2 weeks and then every week! (gotta love private healthcare).

I think I will take the aspirin, do some more research and have another chat with him in 2 weeks time when I go back.

This mummy guilt is insane! Argh! X(

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Wednesday, November 10th 2010, 4:41pm

Being a mummy to a beautiful daughter you know only too well how bad mummy guilt can be! Whatever you do, no one will ever be able to give you categorical answers on anything really. Medicine just doesn't work like that. Sounds like your doctor is v thorough though, and that has to be reassuring.

xxx

  • "qwerty" started this thread

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Thursday, November 11th 2010, 12:20pm

Ah well, I have changed my mind again and decided not to take the aspirin and I will talk to the doc in a couple weeks time about it. If the main reason he has put me on aspirin is to prevent miscarriage then I am going to not take it as I am already taking progesterone. And seeing that I can't find much on the prevention of IUGR with aspirin, I am not going to risk taking it!

Thanks everyone for all your answers.

x

ICSI March 2008 BFP, then early m/c, Natural BFP May 2008, m/c at 6 weeks
Natural :BFP: 08/08/08!!!



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Thursday, November 11th 2010, 12:45pm

congratulations on your bfp
i hope everything goes well this time

i was prescribed clexane and baby aspirin and progesterone this time but it doesnt seem to have done any good (m/c around 6w again)
but then i didnt think it would as i have had some clotting factor tests done a year ago and they were apparently normal

there is deffo a lot of reading on the aspirin/clexane debate!

good luck with your decision on not taking it, i hope your specialist agrees next time you see him ana in 7-8 months time your daughter gets to be a big sister

x

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