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Discuss how the Kristen Swanson Caring Theory is related to the essay below:
The Effectiveness of Aspirin and Physical Activity in Reducing the Risk of Preeclampsia during Pregnancy.
Preeclampsia is a significant cause of prenatal mortality and morbidity among pregnant women. It can lead to a variety of negative health outcomes for both the mother and the baby after 20 weeks of gestation age, including multiorgan damage, preterm birth, intrauterine growth restriction (IUGR), small for gestational age (SGA) birth, or even death (Davidson et al., 2021). Factors that raise the risk of preeclampsia for pregnant women include a history of preeclampsia, multifetal gestation, type 1 and 2 diabetes, renal disease, an age of 35 years or older, African American/Black, obesity (BMI > 30), autoimmune disorder, chronic hypertension, and personal history factors. It is important for providers to screen pregnant women and provide appropriate treatment plans for those with a high risk of preeclampsia. Due to its contribution to maternal and perinatal mortality and morbidity, extensive research on preeclampsia has focused on determining valuable prevention measures. Daily low dose Aspirin (ASA) and daily physical activity have both been recommended to reduce the risk of preeclampsia in a high-risk pregnant women during 9 months of pregnancy. This paper presents the efficacy of daily low-dose ASA compared to daily physical activity for helping prevent preeclampsia in high-risk women during the pregnancy period.
ASA is known as acetylsalicylic acid. It has both anti-inflammation and anticoagulant properties that reduce inflammation, fever, and pain. In addition, it blocks platelet action, which prevents blood clots from forming (Davidson et al., 2021). In pregnant women, preeclampsia can cause vascular disturbances and coagulation defects which then lead to negative outcomes for both the mother and the baby (Davidson et al., 2021). ASA works to promote vasodilation and inhibit platelet aggregation, which results in increased blood flow to the uterus and placenta (Davidson et al., 2021). Therefore, ASA helps reduce complications such as SGA birth, IUGR, preterm birth, preeclampsia, and perinatal mortality. The dosage of low-dose ASA ranges from 60-150 mg depending on the risk and gestational age of the pregnant woman (Davidson et al., 2021). The US Preventive Services Task Force (USPSTF) recommended the use of 81 mg of ASA daily in pregnant women with a higher risk of preeclampsia (Davidson et al., 2021). According to Davidson et al., 81 mg of ASA has a relative risk reduction of 21% in pregnant women who have more than one moderate-risk factor for preeclampsia (2021). ASA should be started after 12 weeks of gestation and continued until delivery (Davidson et al., 2021). Another study showed that 60 mg of ASA daily reduced the risk of preeclampsia by 10%, while 150 mg of ASA daily can lead to a 28% reduction of preeclampsia (Henderson et al., 2021). However, the study did not indicate the starting time of ASA with relation to the gestational age (Henderson et al., 2021). According to Roberge et al. (2018), starting the administration of ASA before16 weeks of gestation and at a dose of equal to or greater than100 mg/day reduces the risk of preterm preeclampsia by approximately 70%. The researcher suggested that pregnant women with a high risk of preeclampsia should be treated with ASA prophylactically, but did not define the high-risk group.
Performing physical activity during pregnancy also offers benefits for pregnant women with high risk of preeclampsia. It helps lower the risk of preeclampsia by reducing oxidative stress, decreasing blood pressure, stimulating placental growth and vascularity, and reducing the effects of placental insufficiency (Witvrouwen et al., 2020). The physical exercise can range from low to moderate intensity exercise (Gao et al., 2020). Awad et al. (2019) suggested that daily prenatal stretching exercises significantly lower the risk of developing preeclampsia. Stretching exercise can affect the autonomic nervous system to reduce stress response and systolic and diastolic blood pressure in the second and third trimester of pregnancy. Another study suggested that pregnant women with a high risk of preeclampsia should perform 5 to 6 hours of vigorous physical activity per week (Witvrouwen et al., 2020). The result showed that the vigorous physical activity has 40% relative reduction in the risk of preeclampsia and 35% reduction in the occurrence of preeclampsia (Witvrouwen et al., 2020).
ASA and physical exercise have been recommended to prevent cardiovascular complications in many patients. This finding of research paper shows that both ASA and physical exercise have significant impact in reducing the risk of preeclampsia. Taking higher dosage of ASA shows higher efficacy in risk reduction of preeclampsia compared to physical activity. While there is a practice standard for provider to recommend pregnant women with a high risk of preeclampsia to take low-dose ASA daily as a prophylactic measure, there is no specific physical exercise recommendation for reducing the risk of eclampsia in all pregnant women (Gao et al., 2020). The topic of this research paper is chosen based on the author’s interest to explore the effectiveness of ASA and physical activity in reducing the risk of preeclampsia in pregnant women with a high risk. It is also important for healthcare providers to have an adequate knowledge of the effects of ASA and physical activity in pregnant women with a high risk of preeclampsia. Providers can educate pregnant patient on the risks and benefit of taking ASA and doing physical activity and help patients overcome potential barriers during pregnancy and improve health outcomes for both the mother and the baby (Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality: Preventive Medication, 2021).
In high risk pregnant women (P), does daily low-dose Aspirin (I) offer greater risk reduction for preterm preeclampsia (O) compared to daily physical exercise (C) during the 9-month pregnancy period (T)?
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