Enoxaparin in the Prevention of Placental Insufficiency in Pregnant Women (PRESANCE)
Placental Insufficiency, Enoxaparin
About this trial
This is an interventional prevention trial for Placental Insufficiency
Eligibility Criteria
Inclusion Criteria:
- Age ≥ 18 years and
- Age ≤ 45 years and
- Single and confirmed pregnancy and
- Intrauterine growth restriction (IUGR) history with an estimated fetal weight (ESW) < 3rd percentile and / or
- In utero fetal death (IUFD) history > 12 weeks of amenorrhea (WA) and / or
- Central Retroplacental hematoma (RPH) history < 34 WA and / or
- History of severe preeclampsia < 34 WA and
- Informed consent, written and obtained
Exclusion Criteria:
- Age <18 years or
- Age > 45 years or
- Multiple pregnancy or
- Pregnancy > 7 WA or
- Positive immunological assessment or
- Known history of Thromboembolic diseases, Hemorrhagic diseases, Systemic Lupus Erythematosus (SLE), Heparin-induced thrombocythemia (HIT), Suspicion of thrombophilia (burdened history) or an episode of Deep Vein Thrombosis (DVT) or
- Anticoagulation required or
- Thrombocythaemia < 100,000 plq / µl or
- Weight > 100 kg or
- Osteoporosis or
- Known allergy to the study products or
- Inability to ensure injections' administration or
- Family history of DVT before 40 years of age or
Sites / Locations
- Maternity Center of Wassila Bourguiba Hospital - Department A
Arms of the Study
Arm 1
Arm 2
Experimental
Other
Arm 1
Arm 2
Patients going on ASPIRIN 100 mg/day combined with ENOXAPARIN 4000 IU per dat prevention treatment according to randomization: Administer Aspirin 100 mg Oral Tablet, Enteric Coated once daily Administer the Enoxaparin preventive dose of 4000 IU as a subcutaneous Enoxaparin 40 mg / 0.4 mL Prefilled Syringe once daily Start treatment from inclusion visit Maintain treatment until the day of delivery, or the appearance of a complication (Retroplacental hematoma (RPH), preeclampsia (PE) , In utero fetal death (IUFD), or Intrauterine growth restriction (IUGR) and its complications)
Patients going on ASPIRIN 100 mg/day prevention treatment alone according to randomization: Administer only Aspirin 100 mg Oral Tablet, Enteric Coated once daily Administer orally Start treatment from inclusion visit Maintain treatment until 35 Weeks of Amenorrhea (WA)