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--- med:preeclampsia_aspirin [2018/10/16 12:57] – V_L
+++ med:preeclampsia_aspirin [2022/11/26 03:48] (현재) – [중단시기] V_L
@@ 줄 2: / 줄 2: @@
 {{page>:틀#의학}}
 ====== 임신중독증 저용량아스피린 ======
+ [[med:preeclampsia|임신중독증]]
+예방을 위한
+//저용량 [[aspirin]] 복용법//은 일반적으로  60-150 mg 을 매일 먹는 것을 말한다. 미국은 한알에 81mg이다.((Low-dose [[aspirin]] ranges from 60-150 mg daily but, in the United States, the usual dose is a 81-mg tablet))
+=====효과=====
+임신중독증 발생률의 위험도를  2-5%가량 낮춘다.((found a 2 to 5% risk reduction in the rate of preeclampsia))
+((A review of 45 randomized trials that included over 20,000 pregnant women taking daily low-dose aspirin showed significant evidence of the prevention of preeclampsia, severe preeclampsia, and fetal growth restriction when initiated before 16 weeks’ gestation.))
+임신 16주 이후에 복용하면 효과가 없었다. ((Low-dose aspirin initiated after 16 weeks’ gestation may not be as effective at reducing the risk of preeclampsia, severe preeclampsia, and fetal growth restriction))
+따라서 상기한 고위험군의 경우 임신초기부터 확인이 되어야 한다((Women at high risk for those outcomes should be identified in early pregnancy))
+=====적응증 =====
+====고위험====
+아래에 하나라도 해당할 경우 저용량 아스피린 요법 권장.
+  * [[med:preeclampsia|]]의 과거력
+  * [[med:multifetal_pregnancy|]]
+  * [[med:고혈압|만성 고혈압]]
+  * [[med:diabetes_mellitus]] (1형 혹은 2형)
+  * 신장질환 (Renal disease)
+  * 자가면역질환 (Autoimmune disease) ([[med:systemic_lupus_erythematosus|]], antiphospholipid syndrome)
-Low-dose aspirin ranges from 60-150 mg daily but, in the United States, the usual dose is a 81-mg tablet
+====중등도====
+아래의 항목 두 개이상 해당할 경우 권장.
-=====시기=====
+  * 초산모 (Nulliparity; never having given birth)
+  * 비만 (body mass index >30 kg/m2)
- You should start taking low-dose aspirin between weeks 12 and 16 of your pregnancy.
+  * 임신중독증 가족력 (mother or sister)
+  * Sociodemographic characteristics (African American race, low socioeconomic status)
+  * Age ≥35 years
+  * Personal history factors (e.g., low birthweight or small for gestational age, previous adverse pregnancy outcome, >10-year pregnancy interval)
-=====효과=====
+====저위험====
+이전에 합병증 없는 만삭 분만한 경우 권장하지 않음.
- A review of 45 randomized trials that included over 20,000 pregnant women taking daily low-dose aspirin showed significant evidence of the prevention of preeclampsia, severe preeclampsia, and fetal growth restriction when initiated before 16 weeks’ gestation. Low-dose aspirin initiated after 16 weeks’ gestation may not be as effective at reducing the risk of preeclampsia, severe preeclampsia, and fetal growth restriction. Women at high risk for those outcomes should be identified in early pregnancy.[v]
+=====안전성=====
+  - 영아사망, 성장저하, 인지기능저하에 증가가 없다.
+  - 태반박리, 산후출혈, 유산에 통계적으로 중대한 영향이 없다.
-found a 2 to 5% risk reduction in the rate of preeclampsia.
+  - 18개월까지 영아성장발달에 차이가 없다.
-=====안전성=====
+(( No increase in infant loss, growth problem s, or cognition harm to the baby;
- No increase in infant loss, growth problems, or cognition harm to the baby;
 No statistically significant impact on risk of placental abruptions, postpartum hemorrhage (bleeding), or miscarriage to the mother;
-No differences in developmental outcomes of the infants up to age 18 months.
+No differences in developmental outcomes of the infants up to age 18 months.))
+=====복용시작시기=====
+보통 임신 12주에서 16주 사이에 복용을 시작한다. ((You should start taking low-dose aspirin between weeks 12 and 16 of your pregnancy))
 =====중단시기=====
-When should I stop taking low-dose aspirin?
-It is very important that you ask your doctor when you should stop taking aspirin, as recommendations may be differ depending on your medical history.
+논란이 있다.
+주 이후에는 분만가능성이 있고, 아스피린 복용시 출혈가능성이 증가하여 36주까지만 먹어야 한다는 의견과, 36주 이후에 [[med:preeclampsia|임신중독증]]이 많이 발생하므로 계속 먹어야 한다는 의견이 있다.
-There are opposing arguments regarding when to discontinue aspirin treatment. Some argue that aspirin should be discontinued at 36 weeks because of the possible bleeding risks associated with delivery.
+((There are opposing arguments regarding when to discontinue aspirin treatment. Some argue that aspirin should be discontinued at 36 weeks because of the possible bleeding risks associated with delivery.
-Others argue, because most preeclampsia occurs after 36 weeks, that the aspirin may be beneficial to continue through delivery, into the postpartum period.
+Others argue, because most preeclampsia occurs after 36 weeks, that the aspirin may be beneficial to continue through delivery, into the postpartum period))
-More research is needed, but again, it is imperative you discuss a stopping point with your healthcare professional if you are on a prenatal aspirin regimen.
+{{:med:preeclampsia_aspirin-113347.png}}
 https://www.preeclampsia.org/aspirin