Preeclampsia is an important cause of maternal and perinatal morbidity and mortality. Previous studies have tested calcium supplementation and aspirin separately to reduce the incidence of preeclampsia but not the effects of combined supplementation. The objective of this study was to investigate the effectiveness of aspirin combined with calcium supplementation to prevent preeclampsia in women with chronic hypertension. A double-blind, placebo-controlled randomized clinical trial was carried out at the antenatal clinic of a large university hospital in São Paulo, SP, Brazil. A total of 49 women with chronic hypertension and abnormal uterine artery Doppler at 20-27 weeks gestation were randomly assigned to receive placebo (N = 26) or 100 mg aspirin plus 2 g calcium (N = 23) daily until delivery. The main outcome of this pilot study was development of superimposed preeclampsia. Secondary outcomes were fetal growth restriction and preterm birth. The rate of superimposed preeclampsia was 28.6% lower among women receiving aspirin plus calcium than in the placebo group (52.2 vs 73.1%, respectively, P=0.112). The rate of fetal growth restriction was reduced by 80.8% in the supplemented group (25 vs 4.8% in the placebo vs supplemented groups, respectively; P=0.073). The rate of preterm birth was 33.3% in both groups. The combined supplementation of aspirin and calcium starting at 20-27 weeks of gestation produced a nonsignificant decrease in the incidence of superimposed preeclampsia and fetal growth restriction in hypertensive women with abnormal uterine artery Doppler.

OBJETIVOS: Avaliar o comportamento da pressão arterial em gestantes portadoras de síndromes hipertensivas na vigência de ciclo de corticóide (esquema de LIGGINS) utilizado para a aceleração da maturidade pulmonar fetal. MÉTODOS: A partir de estudo retrospectivo, foram avaliadas 27 gestantes portadoras de hipertensão arterial, com idade gestacional entre 24 e 34 semanas, submetidas a corticoterapia antenatal. Para tanto, foi realizada análise estatística das médias das pressões arteriais sistólicas e diastólicas separadamente, dos dias anterior, primeiro e segundo dias que compõem o ciclo de corticoterapia e do dia posterior a este ciclo. Obtidas as variâncias, foi aplicado o teste F Statistic, analisado através do valor de p, significante, se menor que 0,05. RESULTADOS: Não foi observada variação significativa dos níveis de pressão arterial, seja sistólica como diastólica, não se identificando dificuldades no controle clínico das pacientes, não tendo sido observada necessidade de elevação das doses de drogas hipotensores utilizadas. CONCLUSÃO: Nossos resultados observaram segurança na utilização de ciclos de corticóides em pacientes portadoras de hipertensão arterial em relação à possíveis agravos dos níveis pressóricos.

PURPOSE: To evaluate the behaviour of blood pressure among hypertensive pregnants during glucocorticoid therapy (LIGGINS scheme) in order to accelerate the maturity of fetal lung. METHODS: In a retrospective study, 27 pregnant with a story of hypertensive disorder, between 24 and 34 weeks, during glucocorticoid cycle were avaluated. For this matter, statistical analisis were performed using the means of systolic (SBP) and diastolic blood pressure during the therapy days, on the day before and on the day after. The results were statistically analyzed with F statistic test ( significant if p<005) RESULTS: There was no statistical variance in blood pressure levels, neither in SBP nor in DBP. There was no difficulty in clinical controls and no change in antihypertensive drugs related to glucocorticoid therapy. CONCLUSIONS: Our results show observe the safety of glucocorticoid therapy among pregnant women with hypertensive disorders related to the possible raising of the blood pressure levels.