Arachidonic acid-induced platelet aggregation and acetylsalicylic acid treatment during pregnancy in women with recurrent miscarriage, a post hoc study.

In this post hoc study, arachidonic acid (AA)-induced platelet aggregation during pregnancy with and without acetylsalicylic acid (ASA) treatment was studied in 323 women with unexplained recurrent first-trimester miscarriage and in 59 healthy women with normal pregnancies. All women had normal AA-induced platelet aggregation in the non-pregnant state. Women with recurrent miscarriage were treated with 75 mg ASA or placebo daily. AA-induced platelet aggregation was measured with multiple electrode impedance aggregometry and presented in units (U), where 1 U = 10 aggregation units x minutes. There were no significant differences in platelet aggregation between placebo-treated women with recurrent miscarriage and healthy women. The mean differences were-0.7 (95%CI; -7.0; 5.6) U in the non-pregnant state, 3.8 (95%CI; -4.6; 12.2) U during the late first trimester and 1.7 (95%CI; -6.7; 10.3) U and 4.1 (95%CI; -3.9; 12.0) U during the early and late third trimester, respectively. ASA reduced platelet aggregation by median -84.0% (Q1; Q3; -89.8; -76.3), -79.9% (-84.7; -69.2) and -75.7% (-83.5; -49.5), respectively, during pregnancy. The degree of inhibition by ASA decreased during the third trimester (p < .0001). There were two (1.9%) complete non-responders to ASA and 32.1% with a partial response. The rate of subsequent miscarriage was not affected by ASA, which did not seem to influence the rate of early miscarriage if treatment was initiated when a viable pregnancy was detectable by ultrasound.

Water aerobics reduces sick leave due to low back pain during pregnancy.

OBJECTIVE: To compare the effect of a land-based, physical exercise program versus water aerobics on low back or pelvic pain and sick leave during pregnancy. DESIGN: Randomized controlled clinical trial. SETTING: Three antenatal care centers. PARTICIPANTS: 390 healthy pregnant women. INTERVENTIONS: A land-based physical exercise program or water aerobic once a week during pregnancy. MAIN OUTCOME MEASURES: Sick leave, pregnancy-related low back pain or pregnancy-related pelvic girdle pain, or both. RESULTS: Water aerobics diminished pregnancy-related low back pain (p=.04) and sick leave due to pregnancy-related low back pain (p=.03) more than a land-based physical exercise program. CONCLUSIONS: Water aerobics can be recommended for the treatment of low back pain during pregnancy. The benefits of a land-based physical exercise program are questionable and further evaluation is needed.