Management of Pregnancies With a History of Venous Thromboembolism: Low‐Dose Low‐Molecular‐Weight Heparin and Low‐Dose Acetylsalicylic Acid Prophylaxis

ABSTRACT Aim Venous thromboembolism ( VTE ), including deep vein thrombosis ( DVT ) and pulmonary embolism ( PE ) carries high risk of adverse maternal and fetal outcomes. This Study aimed to evaluate the effectiveness of low‐dose low‐molecular‐weight heparin ( LMWH ) combined with low‐dose acetylsalicylic acid ( ASA ) prophylaxis in women with a history of VTE . Methods A total of 77 pregnant women with a history of VTE (42 DVT, 35 DVT + PE) received daily prophylaxis with low‐dose LMWH (enoxaparin, 1 × 2000 anti‐Xa IU/0.2 mL) and low‐dose ASA (100 mg/day) upon confirmation of pregnancy. Gestational outcomes under prophylaxis were compared with their 256 previous pregnancies. Results 77.9% of the study cases were with maternal risk factors/comorbidities for thrombosis and obstetric complications. LMWH + ASA significantly reduced adverse gestational outcomes (71.9% vs. 46.8%, p < 0.001), including miscarriage (63.3% to 26%, p < 0.001) and preeclampsia (9%–1.3%, p = 0.022). No thrombotic events occurred. Conclusions Prophylactic use of low‐dose LMWH and low‐dose ASA is effective in the prevention of thrombotic events and improves gestational outcomes in women with a VTE history.