How is Aspirin use managed in fetal growth restriction?

Question

Hi doctor,

I have stage 1 fetal growth restriction. I had subchorionic haemorrhages in the early trimester of pregnancy and a clot. I have taken medicines like Duphaston and Trapic in the past, only to stop bleeding. Yesterday, at the 33rd week, I took the first dose of Betamethasone (lung maturity injection) in the morning. Yesterday, I stopped Ecosprin, as the doctor advised. Today, I took the second dose in the morning. Can I take Ecosprin 150 mg today itself?

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I hear you and this is a very important question, especially when there is a history of stage 1 foetal growth restriction (FGR) subchorionic haemorrhage or clot. The main thing to remember here is that if your doctor has told you to stop taking Ecosprin (Aspirin 150 mg) then you should not restart yourself today. Because when your ob/gyn tells you to stop (especially at 33 weeks) it is usually for a specific reason, such as:

Risk of bleeding.
Placental issues.
If necessary, prepare for early delivery.
Steroid course / monitoring phase.

Betamethasone injections do not directly conflict with Aspirin, but the decision to re-start Aspirin depends on your Doppler flow, bleeding history, platelet status, and delivery risk.

Why it should not be taken tonight without approval. Because you had:

Previous Subchorionic haematoma.
History of a clot.
FGR stage 1 now and the doctor said stop yesterday specifically.

Resumption of Aspirin may be associated with placental bleeding, occult bleeding, worsening bleeding (rare but serious) and complications in the event of an emergency delivery.

In many cases of FGR, aspirin is continued until about 34 to 36 weeks, but some doctors may stop it earlier, depending on a history of bleeding, Doppler changes and the planned time of delivery. So both are there but what your doctor says is most important because they know your scans.

Regards.