ClinicalTrials.gg
RecruitingNCT06004674Updated Jul 23, 2026

Using Placental Pathology to Prevent Recurrent Adverse Pregnancy Outcomes: A Pilot Project

A Phase 2 interventional study of Lovenox 40mg in Adverse Pregnancy Outcome, sponsored by Endeavor Health. Recruiting at 1 site in United States. Open to participants aged 18 Years to 60 Years. Per ClinicalTrials.gov, last updated 2026-07-23.

Sponsored by Endeavor Health · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Dec 2023; still recruiting 2 years 10 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
20
Allocation
Randomized
Ages
18 Years to 60 Years
Sex
All
01

Study summary

The goal of this randomized clinical trial is to evaluate if we can use placental pathology in a prior pregnancy which had an adverse outcome, such as early delivery, stillbirth, a baby born smaller than expected, or severe forms of high blood pressure during pregnancy, to guide treatment in the subsequent pregnancy and reduce risk of recurrent adverse pregnancy events.

The main questions it aims to answer are:

  • Whether enoxaparin prevents recurrent adverse pregnancy outcomes among patients with a prior adverse pregnancy outcome that occurred in the setting of maternal vascular malperfusion (MVM).
  • If enoxaparin reduces the occurrence or severity of MVM among patients with a prior adverse pregnancy outcome that occurred in the setting of MVM.
Read the detailed description

In this clinical trial, participants will undergo consent, blood samples will be collected, and participants will be randomized in a 1:1 ratio to the enoxaparin or control groups at their first study visit.

  • Participants will return for a study visit within 1 week following randomization.
  • If assigned to the enoxaparin, the participant will be asked to take a dose of the enoxaparin once a day (40 mg daily) daily from 12 0/7 weeks and/or the start of enrollment (whichever is later) and continue until 36 weeks gestational age, after which enoxaparin will be discontinued.
  • Participants in the control group will have care as usual, with no additional medications.
  • During this study, a study team member will collect a blood sample from all participants at 20-24 weeks, 32-34 weeks, and at delivery.
  • Participants in the enoxaparin group will have their blood work checked a week after starting medication to ensure that they have no unanticipated side effects.

Researchers will compare the enoxaparin group to the control group to see if enoxaparin prevents or reduces the occurrence or severity of maternal vascular malperfusion (MVM) among patients with a prior adverse pregnancy outcome.

02

Conditions studied

  • Adverse Pregnancy Outcome

Keywords

  • miscarriage
  • preeclampsia
  • preterm delivery
  • stillbirth
  • Low birth weight
03

In context

Abortion, Spontaneous

221 studies on the registry are indexed under Abortion, Spontaneous; 44 are open to participants now.

This study's planned enrollment of 20 is below the median of 150 across 120 interventional studies indexed under Abortion, Spontaneous.

Browse Abortion, Spontaneous studies →

Lead sponsor

Endeavor Health is the lead sponsor of 111 studies on the registry; 34 are open to participants now.

Of its 12 completed or terminated interventional studies of FDA-regulated products, 9 (75%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Eligibility Criteria:

Inclusion criteria

Inclusion (must meet all three criteria):

  1. Subjects with a prior adverse outcome in a prior pregnancy. Adverse outcome is defined as prior singleton preterm birth ( \< 37 weeks), SGA infant (defined as birthweight \< 10th percentile), preeclampsia with severe features, or stillbirth (fetal demise after 20 weeks gestation), as certified by an obstetrician
  2. Patients with maternal vascular malperfusion on pathology from pregnancy with prior adverse pregnancy outcome, as certified by a perinatal placental pathologist
  3. Current singleton pregnancy at \<16 6/7 weeks gestational age.

Exclusion criteria

Exclusion Criteria:

  1. Anticoagulation planned for current pregnancy (including warfarin, enoxaparin, heparin)
  2. Known major fetal anomaly
  3. to enoxaparin: Specifically active major bleeding, known thrombocytopenia ( \<100), to enoxaparin sodium, hypersensitivity to heparin or pork products, hypersensitivity to benzyl alcohol
  4. Chronic kidney disease with \< 60
  5. Known chronic liver disease with baseline /ALT > 3 x
  6. Subjects with mechanical prosthetic heart valves
Terms in these criteria, in plain language(6)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
20 participants (estimated)

Study arms

  • Experimental
    Enoxaparin Group

    Participants in the enoxaparin group will be asked to take a dose of the enoxaparin once a day (40 mg daily) daily from 12 0/7 weeks and/or start of enrollment (whichever is later), and continue until 36 weeks gestational age, after which enoxaparin will be discontinued.

    Drug: Lovenox 40mg

  • No intervention
    Control Group

    Participants in this group will have standard care as usual, with no additional medications.

Interventions

  • Enoxaparin is a blood thinner. It is approved for use in the prevention of deep vein thrombosis (DVT) in abdominal surgery, hip replacement surgery, knee replacement surgery, or medical patients with severely restricted mobility during acute illness; inpatient treatment of acute DVT with or without pulmonary embolism; outpatient treatment of acute DVT without pulmonary embolism; Prevention of ischemic complications of unstable angina and non-Q-wave myocardial infarction; treatment of acute ST-segment elevation myocardial infarction(STEMI) managed medically or with subsequent percutaneous coronary intervention. The use of Lovenox has been shown to be safe, and it has also been used widely off-label in pregnancy.

    Also known as: Enoxaparin

06

What researchers measure

Primary outcomes

  1. Composite Adverse Pregnancy outcome

    Preeclampsia with severe features, small for gestational age infant, preterm delivery \<37 weeks, neonatal death, and maternal death

    Time frame: Enrollment through 6 weeks postpartum

Secondary outcomes

  1. Maternal vascular malperfusion (MVM)

    Presence/ absence of MVM on placental pathology

    Time frame: Placenta collected at time of delivery

  2. Preeclampsia with severe features

    Defined by clinician

    Time frame: Enrollment through 6 weeks postpartum

  3. Small for gestational age infant

    By Fenton criteria

    Time frame: At time of delivery

  4. Preterm delivery < 37 weeks

    Time frame: Assessed at time of delivery

  5. Neonatal Death

    Time frame: Assessed from time of delivery to 6 weeks postpartum

  6. Maternal Death

    Time frame: Assessed from enrollment to 6 weeks postpartum

07

Study locations

1 of 1 sites recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 23, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT06004674
Lead sponsor
Endeavor Health
Responsible party
Sunitha Suresh (Physician, FPA, Endeavor Health) — Principal investigator
First posted
Aug 22, 2023
Start date
Dec 26, 2023
Primary completion
Mar 2027 (estimated)
Completion
Mar 2027 (estimated)
Last update
Jul 23, 2026

Study contacts

Sunitha Suresh
Contact
SSuresh@northshore.org
(847) 570-2860
Kate Honeyfield
Contact
KHoneyfield@northshore.org
847-570-2243
Sunitha Suresh
principal investigator · Endeavor Health

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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