A 35-year-old woman has a history of pre-eclampsia in her previous pregnancy at 34 weeks. She is currently 12 weeks pregnant with a singleton gestation. According to NICE and ACOG recommendations, which intervention is indicated for pre-eclampsia prevention?
- A Antenatal corticosteroids at 12 weeks
- B Calcium supplementation 1.5-2 g daily regardless of dietary intake
- C Low-dose aspirin 75-150 mg daily initiated between 12-16 weeks ✓
- D Prophylactic magnesium sulfate from 12 weeks
Correct answer: C. Low-dose aspirin 75-150 mg daily initiated between 12-16 weeks
Explanation
Both ACOG and NICE recommend low-dose aspirin (81-150 mg in ACOG; 75-150 mg in NICE) initiated between 12-28 weeks (optimally before 16 weeks) for women at high risk of pre-eclampsia, including prior pre-eclampsia. Calcium supplementation is recommended only in low-intake populations. Antenatal corticosteroids are for fetal lung maturation, not pre-eclampsia prevention. Prophylactic magnesium sulfate is for seizure prophylaxis in diagnosed severe pre-eclampsia, not prevention.
Reference: Williams Obstetrics, 26th ed.
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