A 34-year-old female, G2P1, with a history of pre-eclampsia in her previous pregnancy, comes for her first ANC visit at 12 weeks. What is the most appropriate intervention for prevention of pre- eclampsia in her current pregnancy?

Appeared in: INI-CET EXAM -2026

Explanation

Low-dose aspirin is the recommended prophylactic treatment for women at high risk of pre-eclampsia, a category that includes a history of the condition in a prior pregnancy.
It works by inhibiting platelet thromboxane A2 production, which helps correct the prostacyclin-thromboxane imbalance characteristic of pre-eclampsia, thereby promoting vasodilation and improving placental perfusion.
Major guidelines, including ACOG, recommend initiating low-dose aspirin (50-150 mg/day) between 12 and 28 weeks of gestation for high-risk women.

Option B: Adding Low Molecular Weight Heparin (LMWH) to aspirin is not the standard first-line prevention for pre-eclampsia. Studies have not shown this combination to be superior to aspirin alone for this purpose.
Option C: Low calcium intake is contraindicated. It does not prevent pre-eclampsia and could be harmful.
Option D: A low-salt diet has been studied and found to be ineffective in preventing pre-eclampsia. It is not a recommended intervention.

Clinical Relevance

Nursing practice connection: Use the key finding related to Pharmacological prevention of pre-eclampsia in high-risk pregnancies to guide bedside assessment, documentation, and the next nursing action.
Nurses are central to patient education regarding adherence to the aspirin regimen and recognizing early warning signs of pre-eclampsia (e.g., persistent headache, visual changes, epigastric pain, rapid swelling).
Accurate and consistent monitoring of blood pressure and screening for proteinuria at every antenatal visit are critical nursing responsibilities for early detection.
What if? If the patient also had a diagnosis of Antiphospholipid Syndrome (APS), the correct intervention would change to a combination of low-dose aspirin and Low Molecular Weight Heparin (LMWH) to prevent both pre-eclampsia and thrombotic events.

How to Approach the Question

First, identify the key patient details from the clinical scenario: a pregnant woman at 12 weeks gestation.
Next, recognize the most significant risk factor presented: a 'history of pre-eclampsia in her previous pregnancy'. This immediately classifies her as being at high risk for recurrence.
The question asks for the 'most appropriate intervention for prevention'. This requires knowledge of current evidence-based guidelines.
Recall the primary prophylactic agent recommended for high-risk women to prevent pre-eclampsia.
Evaluate the given options. Low-dose aspirin is the established first-line agent. The other options are either not evidence-based (low salt, low calcium) or are reserved for specific co-morbidities (LMWH).

Concept Tested & Keywords

Concept Tested: Pharmacological prevention of pre-eclampsia in high-risk pregnancies.
Stem keywords: 34-year-old female, G2P1, history of pre-eclampsia, ANC visit, 12 weeks, prevention of pre-eclampsia
Lead-in keywords: most appropriate intervention
Clinical cues: History of pre-eclampsia is a high-risk factor, making prophylaxis a key consideration.
Clinical cues: 12 weeks gestation is the ideal time to initiate preventive therapy.

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E6 Obstetrics Williams p. 17-33

Practise the full INI-CET EXAM -2026

Attempt every question from this paper in a timed mock, then review the full solution for each one.