Question

In a woman at high risk because of a past history of pre-eclampsia, which is the best method to prevent pre-eclampsia in the current pregnancy?

• A. Low-dose aspirin started from 12 weeks of gestation
• B. Aspirin combined with low-molecular-weight heparin (LMWH)
• C. Strict salt (sodium) restriction
• D. Calcium supplementation

Hint:

Start low-dose aspirin early — before 16 weeks — in high-risk women.

Answer 1

The Correct Option is A

Step 1: Identify the risk category. A previous history of pre-eclampsia makes the patient high risk for recurrence, so an evidence-based prophylactic intervention is indicated.

Step 2: Recall the guideline-backed prophylaxis. For high-risk women, low-dose aspirin (≈75-150 mg/day) started in the late first trimester — by 12-16 weeks, ideally before 16 weeks — and continued until delivery is the best-proven method to reduce the incidence of pre-eclampsia. Aspirin improves the placental prostacyclin:thromboxane balance during early trophoblastic invasion.

Step 3: Select the option. 'Aspirin from 12 weeks' (option 1) matches this recommendation exactly and is the single most effective preventive strategy.

Step 4: Why the others are wrong. Adding LMWH (option 2) is not routinely recommended for pre-eclampsia prevention and is reserved for specific thrombophilia/recurrent loss situations — there is no consistent benefit over aspirin alone for pre-eclampsia. Salt restriction (option 3) does NOT prevent pre-eclampsia and is not advised. Calcium (option 4) helps only in populations with low dietary calcium intake and is a second-line measure, far less effective than aspirin in a high-risk woman.

Key fact: Low-dose aspirin begun before 16 weeks (commonly from 12 weeks) is the best prophylaxis against pre-eclampsia in high-risk women.