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

A prior pre-eclampsia flags this pregnancy as high risk, so the question is really asking for the prophylaxis with the strongest evidence base.

That intervention is low-dose aspirin. Given early — by 12 to 16 weeks and ideally before 16 weeks — and continued to delivery, aspirin shifts the placental prostacyclin-to-thromboxane ratio at the time of trophoblast invasion and meaningfully lowers the rate of pre-eclampsia and its severe, early-onset forms. The stem's option of starting aspirin from 12 weeks captures this perfectly.

The remaining choices fall short. Pairing aspirin with LMWH adds no reliable pre-eclampsia benefit and is reserved for thrombophilia or recurrent pregnancy loss. Cutting salt has never been shown to prevent the disease. Calcium only helps where baseline dietary calcium is low and is at best adjunctive, not the best single answer for a high-risk woman.

$\text{High risk + start} \le 16\text{ wk} \Rightarrow \text{low-dose aspirin}$

\[\boxed{\text{Aspirin from 12 weeks}}\]