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PICOT Study:determine which between a low daily dose of aspirin (LDA) and Physical Exercise is most effective at reducing the PE risk during a high-risk pregnancy.€30,47
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PICOT Study:determine which between a low daily dose of aspirin (LDA) and Physical Exercise is most effective at reducing the PE risk during a high-risk pregnancy.
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Health Care and Life Sciences: Nursing
Instelling
Health Care And Life Sciences: Nursing
Picot Question: In high-risk pregnant women (P), does daily low-dose Aspirin (I) offer greater risk reduction for preterm Preeclampsia (O) compared to daily physical exercise (C) during the 9-month pregnancy period (T)?
does daily low dose aspirin i offer greater risk reduction for preterm preeclampsia o compared to daily physical exer
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Health Care and Life Sciences: Nursing
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Introduction
Preeclampsia is a prenatal condition that often manifests during the 20th week of
pregnancy characterized by elevated blood pressure and proteinuria. Prevalence of this condition
among pregnant women is assessed to range between 2 and 8% globally (Raguema, Benletaifa,
Mahjoub, & Lavoie, 2020). It is regarded as the primary global root of maternal and fetal death
and morbidity (Raguema, Benletaifa, Mahjoub, & Lavoie, 2020). Although some data suggest
that the condition stems from vascular endothelial cell dysfunction relative to the declining
synthesis of vasodilators, a definite cause is yet to be established. Preeclampsia poses a
significant risk during pregnancy, but antihypertensive medications may also endanger the fetus
or the mother (Awad, Hasanin, Taha, & Gabr, 2019). This analysis aims to determine which
between a low daily dose of aspirin (LDA) and Physical Exercise is most effective at reducing
the PE risk during a high-risk pregnancy.
PICOT Question
In high-risk pregnant women (P), does daily low-dose Aspirin (I) offer greater risk reduction for
preterm Preeclampsia (O) compared to daily physical exercise (C) during the 9-month pregnancy
period (T)?
Literature Review
Effects of Low Daily Dose of Aspirin (LDA) on Preterm Preeclampsia (PE)
Studies on the effects of LDA on PE in pregnant women have been conducted for more
than 40 years, however, the results are still inconclusive due to contradicting outcomes
( Shanmugalingam, et al., 2020). One of the key issues behind the inconsistencies in these
studies is the utilization of different variables. For example, even among studies that find LDA to
be effective, the recommended Dosages might differ. Subsequently, in this analysis, we'll
, establish 50-150 Milligrams Dosage (mg/d) of Aspirin as the LDA parameter, and identify
possibilities of Aspirin resistance, Non-adherence, and any other factors that might compromise
data validity.
An investigation into the demographics of Asia and the impact of LDA on PE among
Asian pregnant women was conducted in China. The major emphasis of the study was 100 mg/d,
for which LDA was found to be ineffective in reducing PE risk from 12, 20 to 34 gestational
weeks. Further research into other dosages 60 mg, 75mg, and 81mg identified that the dosage
was also ineffective. However, the study identified that 150mg of Aspirin was effective in
mitigating the risk of PE (Lin, et al., 2021). Henderson, Vesco, Senger, Thomas, & Redmond
(2021) study, performed a similar study except for the location and demography. The findings
identified that different dosages were effective including, 10% efficacy at 60mg/d, greater
efficacy at 75mg/d, and 28% efficacy at 150mg/d. It's important to consider that the US
Preventive Service Task Force (USPSTF) recognizes 81 mg/d as a low dosage in the study.
Further, while Henderson, Vesco, Senger, Thomas, & Redmond's (2021) study identified
different rates of PE among different races, it's important to note that Lin, et al., (2021)
highlights that china's LDA is typically suboptimal. Consequently, the difference in effectivity is
likely a result of the potency of the Aspirin i.e., the potency difference between Aspirin supplied
in America and those from China.
To acquire valid data that supports the effectiveness of LDA in minimizing the risk of
PE, we must consider an issue raised in the aforementioned studies. Although the difference in
potency in the supply of Aspirin might explain the variance in effectiveness, the question of
whether ethnicity plays a factor cannot be ignored. According to the Henderson, Vesco, Senger,
Thomas, and Redmond (2021) study, racial differences in PE prevalence exist. In contrast to
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