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Clinical and geographical variation in prophylactic and therapeutic treatments for pre-eclampsia in the UK

Research output: Contribution to journalArticle

L. C. Chappell, P. Seed, S. Enye, A. L. Briley, L. Poston, A. H. Shennan

Original languageEnglish
Pages (from-to)695 - 700
Number of pages6
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Volume117
Issue number6
DOIs
Publication statusPublished - May 2010

King's Authors

Abstract

Objective To evaluate the clinical and geographical variation in the use of aspirin in women at high risk of pre-eclampsia, and in the use of antihypertensive drugs and magnesium sulphate in women with established pre-eclampsia. Design Analysis of vitamins in pre-eclampsia (VIP) trial database. Sample A total of 2399 women at increased risk of pre-eclampsia in 25 UK hospitals. Methods An analysis of a large prospectively validated database of high-risk women in the UK was undertaken to assess aspirin use across different risk groups and to evaluate the use of antihypertensives and magnesium sulphate in 370 women who developed pre-eclampsia. Logistic regression was employed to compare drug use between region and by recognised clinical indicators. Main outcome measures Usage of aspirin, antihypertensive drugs and magnesium sulphate. Results Of the women with known risk factors at trial entry, 24% (569/2399) received low-dose aspirin. Aspirin usage varied widely between risk groups [from 5% (19/378) in women with multiple pregnancy to 94% (50/53) in women with antiphospholipid syndrome] and between geographical regions [from 8% (20/248) to 49% (95/193)]. Three hundred and seventy women developed pre-eclampsia, 52% (n = 193) of whom received new or additional antihypertensives after 20 weeks of gestation; 34% (77/224) with a maximum recorded systolic blood pressure of >= 160 mmHg in the second half of pregnancy did not receive antihypertensive treatment; 17% (62/370) of women with pre-eclampsia received magnesium sulphate prophylactically. Conclusions Prophylactic and treatment regimes for pre-eclampsia in the UK vary by region and risk group.

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