The effect of acetylsalicylic acid intake on fetal adaptation in placental dysfunction
Authors: Leush S.S. , Ter-Tumasova A.G. 
Published: May 2024

Placental dysfunction (PD) is one of the actual topics of research in the modern scientific world. Fetal growth retardation (FGR) is the leading clinical manifestation of chronic PD. Assessment of fetal growth is one of the key tasks in prenatal care. FGR is associated with an increased risk of perinatal morbidity and mortality, with long-term adverse outcomes for the child.Prenatal diagnosis of FGR is an important task for stillbirth prevention, up to 30% of cases of which are associated with this pathology or with a small-for-gestational-age fetus at the end of the III trimester.The objective: to study the influence of acetylsalicylic acid on the development of compensatory abilities of the fetus by PD.Materials and methods. 118 pregnancies with FGR and/or PD were analyzed. The women were divided into two groups: I group (67 persons) – patients with FGR and/or PD who used acetylsalicylic acid during pregnancy; II group (51 women) – pregnant women with FGR and/or PD who did not use acetylsalicylic acid during pregnancy. In all cases, the method of delivery was cesarean section due to fetal distress.Fetal distress was diagnosed using ultrasound examinations based on the following criteria: abnormal blood flow according to Doppler data (Volusun S10 ultrasound device), fetal biophysical profile indicators (Volusun S10 ultrasound device, Sonicaid Team fetal monitor) and cardiotocographic assessment of short-term variability (STV) fetal heart rate; STV > 4.5 according to the Sonicaid Team fetal monitor. Exclusion criteria: multiple pregnancy, antenatally confirmed fetal malformations.Results. The use of acetylsalicylic acid through placental regulation allows to achieve a longer gestation period before the development of fetal distress. The average gestational age before the appearance of this pathology in 50.75% of patients of the I group (34 persons) was larger – 33–36 weeks. On the other hand, 54.9% of women (28 individuals) in the II group had fetal distress earlier – at 28–32 weeks of gestation (p<0.05).Pathological blood flow in the umbilical artery or fetal biophysical profile <4 points was determined in 83.6% of cases in the I group (56 pregnant women) and in 23.5% in the II group (12 women). In women who used acetylsalicylic acid (I group) acute fetal distress diagnosed by STV was detected in 11 (16.4%) cases. In women who did not use acetylsalicylic acid (II group), distress manifested itself sharply – due to acidosis – in 39 (76.5%) cases (p<0.05).Conclusions. 1. In women who did not use acetylsalicylic acid, fetal distress manifested itself sharply – due to acidosis (STV<4.5 was recorded in 39 (76.5%) patients of the II group, while in women who used acetylsalicylic acid – in 11 pregnant women of the I group (16.4%; p<0.05). 2. Prophylactic use of acetylsalicylic acid allows to slow down the growth of placental dysfunction, which lets to the development of compensatory mechanisms and adaptation. 3. By use of acetylsalicylic acid the gestational period delivery closer to full term pregnancy. In women who used acetylsalicylic acid, most cases of fetal distress occurred at 33–36 weeks – 50.75%, while in the group that did not use acetylsalicylic acid most cases of fetal distress occurred at 28–32 weeks – in 54.9% (p<0.05).