Aspirin for Treatment of Toxemia

Dr. Brewer’s response to CLASP: a randomised trial of low-dose aspirin for the prevention and treatment of pre-eclampsia among 9364 pregnant women. Lancet 1994; 343:619-29

“Thanks so much for your letters and newsletters. Salt restriction is common here in late pregnancy for oedema, excess weight gain and toxaemia and it won’t change until the public can learn how harmful it is for pregnant moms and fetuses.

“I studied Dr Redman’s CLASP report all day and yesterday. I am amazed at how much support this ‘large numbers, randomized’ study received from pregnant moms and all the thousands of ‘health professionals’ in the U.K. and fifteen other countries. Obviously they really don’t know the now obvious causal links between human pregnancy pathophysiology/pathology and poor diet. I’m sure I begged Redman, Chalmers and Jane Green at NPEU to at least set up some sort of protocol for an adequate diet to prevent nutrient lack all through late pregnancy.

“As I have stressed for years from the internal medicine point of view “hypertension” by itself is not a disease. At my medical school, Tulane University, New Orleans, we were taught not to make a diagnosis of hypertension until it has been seen to persist at least six months. In OB I was taught hypertension in pregnancy that lasts 6 hours is a disease. In short, pre-eclampsia in a large study like this based on blood pressure rise is not a reliable clinical diagnosis, even when linked with edemaSwelling,-water-retention,-puffiness.-(a... and proteinuria,etc., and especially not when you have no knowledge of what the ‘pre-eclamptic’ mom has been eating, what is her emotional status, life-style, medical history, etc., such as your own ‘members experiences’.

“When Redman, Chalmers, et al, begin to publish such information, which is just as available to them as it is to us, it will be real progress. CLASP will help us because it will create more interest in the problem; if aspirin won’t help prevent damage to mom and fetus, what will? Haven’t PETS people been trying to teach U.K. moms the needed facts in this field for over a decade?

“In my opinion the statistics on proteinuric pre-eclampsia developing after randomisation are worthless, meaningless; but the data on ‘eclampsiaA-convulsive-state:-an-attack-of-convuls...’ are another story.

“Here are real world, two groups of pregnant moms ‘randomized’, 4000 approximately in each group, one received 60 mg aspirin daily and the other received a placebo. Of these 8000 pregnant moms, 14 developed eclampsia, 7 in each group. Obviously 60 mg aspirin daily cannot prevent convulsive/coma MTLPMetabolic-Toxemia-of-Late-Pregnancy---th... (metabolic toxaemia of late pregnancy as I term the condition). Also the rates of stillbirth and neonatal deaths are the same in each group. The baby aspirin has no protective effects on ‘real world, real time persons’ health.”

Thomas Brewer M.D., U.S.A.
PETS Newsletter No. 33, Page 4

References:

CLASP: a randomised trial of low-dose aspirin for the prevention and treatment of pre-eclampsia among 9364 pregnant women. CLASP (Collaborative Low-dose Aspirin Study in Pregnancy) Collaborative Group. The Lancet, 343(8898):619-29 1994, Mar 12.

Levine RJ, et al. “Trial of calcium to prevent preeclampsiaA-toxic-condition-developing-in-late-pre....” Editorial comments p. 124, 125. N Engl J Med, 337(2):69-76, 1997, Jul 10.

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