Low-dose aspirin (75–150 mg/day) for pre-eclampsia prevention is most effective when started at what gestational age for women with high-risk features?

• A Before 8 weeks of gestation
• B Before 16 weeks of gestation ✓
• C At 20 weeks of gestation
• D At 24 weeks of gestation

Explanation

Meta-analyses and the ASPRE trial (2017) demonstrate that low-dose aspirin (150 mg/day at night) initiated before 16 weeks of gestation significantly reduces the risk of preterm pre-eclampsia (by approximately 62% in ASPRE) in high-risk women identified by first-trimester combined screening (uterine artery PI, MAP, PAPP-A, PlGF). Aspirin started after 16 weeks is substantially less effective. Current NICE and FIGO guidelines recommend starting aspirin by 12–16 weeks.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.