Prophylaxis of Recurrent Preeclampsia: Low-Molecular-Weight Heparin plus Low-Dose Aspirin versus Low-Dose Aspirin Alone

Objective: To verify whether prophylaxis with low-molecular-weight heparin (LMWH) and low-dose aspirin (LDA) could positively affect pregnancy outcome in women with a history of severe preeclampsia. Methods: We compared 23 pregnancies treated with LDA alone to 31 pregnancies treated with LMWH plus LDA. Results: Women treated with LMWH-LDA (n = 31) showed a better pregnancy outcome than those treated with LDA alone (n = 23) in terms of gestational age at delivery (p < 0.05), birth weight (p < 0.01), birth weight percentile (p < 0.01), and rate of preeclampsia (p < 0.01). Furthermore, comparing the intra-group outcome variation between previous and index pregnancies, an improvement appeared in each group, but a more pronounced gain was noted in the LMWH-LDA group in terms of gestational age at delivery (p< 0.005), birth weight (p < 0.005), and birth weight percentile (p < 0.005). Conclusions: Thromboprophylaxis with LMWH plus LDA can improve pregnancy outcome in women with previous severe preeclampsia.