The EPPI Trial – Enoxaparin for the Prevention of Preeclampsia and Intrauterine growth restriction – a pilot randomised open-label trial.

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Brief summary: Preeclampsia and fetal intrauterine growth restriction (IUGR) are common complications during pregnancy that can cause long lasting health effects for mother and baby in later life. It is believed both conditions are caused by abnormal development of the placenta (whenua/after-birth) and can often recur in future pregnancies. There are several therapies that have been studied to prevent these diseases but, until now, none have been proven to be very effective. Heparin is a drug that prevents blood clots and is believed to help the placenta to develop well. Some studies have suggested that heparin may reduce the risk of preeclampsia and IUGR but this has not been properly assessed in a randomised trial. Our study will invite women who have had a previous pregnancy severely affected by these conditions. Half of the women will be given the heparin injection each day as well as current standard of care (aspirin for all women and calcium for women with previous preeclampsia) and the other half will receive the current standard of care. All women will be monitored very closely. At the end of the study we will be able to assess if the heparin injections reduce the risk of preeclampsia and IUGR.