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Women with histories of severe preeclampsia are at high risk for placenta-mediated pregnancy complications in subsequent pregnancies. In a randomized multicenter trial, 257 women with personal histories of severe preeclampsia before 34 weeks' gestation were randomized at ≤14 weeks' gestation to received enoxaparin (40 mg subcutaneous daily) plus aspirin (100 mg daily; E plus A) or aspirin (A alone) for the remainder of the pregnancy. The primary composite endpoint included maternal death, perinatal death, preeclampsia, small for gestational age at birth, and placental abruption.
Women in the E plus A and A alone groups showed no significant difference in the primary composite endpoint (34% and 41%; relative risk, 0.84; 95% confidence interva…