Aspirin Timing Pre-eclampsia CKD — ESENeph MCQ

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HardPregnancy & RenalAspirin Timing Pre-eclampsia CKDESENeph

A woman with CKD G3a presents for antenatal review at 11 weeks. She has no aspirin allergy or bleeding contraindication. What pre-eclampsia prophylaxis should be planned?

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Correct answer: A — Start aspirin 75–150 mg daily from 12 weeks

The best answer is “Start aspirin 75–150 mg daily from 12 weeks”. NICE treats CKD as one high-risk factor sufficient for low-dose aspirin prophylaxis from 12 weeks until birth. “Start aspirin 75 mg daily after hypertension develops” is less appropriate because CKD itself is a high-risk factor and prophylaxis precedes clinical disease “Start aspirin 75–150 mg daily from 28 weeks” is less appropriate because NICE specifies initiation from 12 weeks “Start clopidogrel 75 mg daily from 12 weeks” is less appropriate because this is not the recommended pre-eclampsia prophylaxis “Use surveillance without antiplatelet prophylaxis during pregnancy” is less appropriate because CKD increases rather than lowers risk

Reference: NICE NG133: hypertension in pregnancy: https://www.nice.org.uk/guidance/ng133/chapter/Recommendations