Low-dose aspirin in nulliparous women: Safety of continuous epidural block and correlation between bleeding time and maternal-neonatal bleeding complications

doi:10.1016/0002-9378(95)90495-6

American Journal of Obstetrics and Gynecology

Volume 172, Issue 5, May 1995, Pages 1553-1557

https://doi.org/10.1016/0002-9378(95)90495-6 Get rights and content

Abstract

OBJECTIVE: Our purpose was to determine the frequency and safety of the use of epidural anesthesia and the correlation between bleeding time and maternal-neonatal bleeding complications in a group of pregnant women who participated in a multicenter trial of low-dose aspirin in pregnancy.

STUDY DESIGN: Data regarding type of anesthesia used for labor and delivery were available in 1629 nulliparous women who were randomly assigned at 13 to 27 weeks to receive 60 mg/day aspirin or a placebo. A total of 891 (55%) received epidural anesthesia, and the remaining 738 did not.

RESULTS: Among the 891 women known to have received epidural anesthesia, 451 were assigned to low-dose aspirin and 440 to placebo. There was no instance of bleeding related to epidural use. In addition, there were no differences in maternal and neonatal complications between those receiving or not receiving epidural anesthesia. Within the group receiving epidural anesthesia there were no differences in bleeding complications between those assigned to aspirin on placebo. One of the five centers also obtained bleeding times in 303 women (149 received aspirin and 154 received placebo). The mean = SD bleeding time in women assigned to low-dose aspirin was significantly higher than in women assigned to placebo (6.99 ± 2.95 minutes vs 5.99 ± 2.43 minutes, p = 0.004). In addition, the frequency of women having a bleeding time > 10 minutes was higher in the aspirin group (14.1% vs 5.2%, p = 0.01). Interestingly, women who received an epidural anesthetic had a lower bleeding time than those not receiving an epidural (p = 0.003), irrespective of the treatment used.

CONCLUSIONS: In women assigned to low-dose aspirin there were no adverse effects related to epidural anesthesia. In spite of an increased bleeding time in a subset of pregnant women assigned to low-dose aspirin, maternal-neonatal bleeding complications were not increased.

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^☆: Supported by National Institute of Child Health and Human Development grants HD 21410, 21434, 21366, 21380, 19897, 21414, 21386, and 21363.

^☆☆: Presented at the Fourteenth Annual Meeting of the Society of Perinatal Obstetricians, Las Vegas, Nevada, January 24–29, 1994.

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General obstetrics and gynecologyLow-dose aspirin in nulliparous women: Safety of continuous epidural block and correlation between bleeding time and maternal-neonatal bleeding complications☆,☆☆

Abstract

Am J Obstet Gynecol

Lancet

Lancet

Am J Obstet Gynecol

Blood

Aspirin in pregnancy

Fetal Matern Med Rev

Effect of low-dose aspirin on fetal and maternal generation of thromboxane by platelets in women at risk for pregnancy-induced hypertension

N Engl J Med

Low dose aspirin in hypertensive pregnant women: effect on pregnancy outcome and prostacyclin-thromboxane balance in mother and newborn

Br J Obstet Gynaecol

Prevention of preeclampsia with low-dose aspirin in healthy, nulliparous, pregnant women

N Engl J Med

Epidurals, spinals, and bleeding disorders in pregnancy: a review

Anaesth Intens Care

General obstetrics and gynecology
Low-dose aspirin in nulliparous women: Safety of continuous epidural block and correlation between bleeding time and maternal-neonatal bleeding complications☆,☆☆