Article Text
Abstract
Background Pre-eclampsia is a leading cause of maternal morbidity and mortality in the UK. NICE guidelines recommend aspirin for prevention of pre-eclampsia. Our aim was to assess current clinical practice for prevention of pre-eclampsia in the UK and prevalence of aspirin use for women with various risk factors.
Methods in May 2011, an electronic survey questionnaire was sent to 1289 consultants in obstetrics and gynaecology in the UK using SurveyMonkey. The RCOG provided a list of consultants with email addresses. A reminder email was sent at 4 and 8 weeks later. Data was analysed using SurveyMonkey.
Results 397 consultants responded to the survey(31%), of whom 305 were practicing obstetrics. Among those practicing obstetrics, 93% used aspirin for prevention of pre-eclampsia. Amongst these, 96% always or usually used 75 mg, but 4% used 150 mg. Aspirin was consistently used by 91% of obstetricians for women with previous severe pre-eclampsia, by 31% for previous pre-eclampsia regardless of severity, by 50% for renal disease, by 52% for chronic hypertension, by 35% for diabetes, by 68% for thrombophilia, and by 24%-32% for >/=2 moderate risk factors, depending on the factors. Calcium was also used by 8% of consultants for prevention of pre-eclampsia, and 53% advised rest to women with hypertension. A few also used folic acid, fish oil, vitamins, low salt diet, and weight control.
Conclusions Over 90% of obtetricians use aspirin for prevention of pre-eclampsia but this is mostly for women with previous severe pre-eclampsia. There is considerable variation in use of aspirin for other risk factors.