[Prevention of preeclampsia].

THE CURRENT SITUATION: Preeclampsia is associated with increased risk of adverse maternal (abruptio placentae, HELLP syndrome, eclampsia.) and perinatal death. Its prevention, therefore, is of particular importance. The latter must be determined together with the group of women who would benefit from it. THE INTEREST OF ASPIRIN: The best studied preventive treatment is low dose aspirin. The various studies on low-dose aspirin have confirmed its safety in pregnant women. These studies, in small cohorts of selected patients at risk or in large series of women with moderate risk, show that the use of aspirin is associated with a 15% reduction in the risk of preeclampsia. OTHER THAN ASPIRIN: Other preventive treatments, such as calcium have not demonstrated their efficacy, or their effect requires confirmation, such as with anti-oxidants or low molecular weight heparin.

IN PRACTICE: The prevention of preeclampsia currently relies on low-dose aspirin started at the beginning of pregnancy. The moderate benefit of such prevention justifies its administration in patients at high risk, selected on their obstetrical past history.