Introduction Pre-eclampsia (PET) contributes significantly to maternal morbidity and mortality. Aspirin prescription is recommended to reduce the incidence of PET. Aspirin treatment for PET prevention was audited against NICE guidelines. Prescriber knowledge was explored to identify whether this was a factor in poor compliance with NICE guidance.

Methods A retrospective audit of deliveries at both a teaching and district general hospital was performed over a 1 month period. Patients' risk of PET according to NICE guidance and subsequent aspirin prescription was noted. Prescriber knowledge was surveyed in both units. Included in this were 16 patient scenarios, 9 of which alluded to aspirin treatment.

Results In district general and teaching hospitals respectively, 14.6% and 21.0% of patients were eligible for aspirin; with 6.4% and 30.8% of those eligible receiving treatment. Prescriber knowledge was best at ST3-5 level. 90.9% of prescribers were aware that aspirin was used to reduce the incidence of PET. Correct identification of ‘theoretical risk’ and eligibility for aspirin ranged between 18.8-100%, mean 65.6%. All knew the recommended dose. 40.9% would commence treatment from 12/40, 50% from conception and 9.1% between 16-20/40. 69.9% would stop treatment at delivery.

Conclusions Prescribers are aware of aspirin use in prevention of PET, with reasonable theoretical knowledge of risk and need for treatment. However, this fails to translate into clinical practice. In both hospitals a significant number of patients qualify for aspirin treatment, but <1/3rd of patients are receiving treatment. Authors recommend that risk assessments for aspirin be incorporated into patient's notes.