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ABSTRACT Objective Design Setting Population Methods Main Outcome Measures Results Conclusions Trial Registration Uncertainty surrounds the risk–benefit of low‐molecular‐weight heparin to prevent postpartum venous thromboembolism (VTE). Data from randomised clinical trials (RCT) are critically needed, but recent feasibility studies in North America yielded low participation rates, with <1 enrolment per month per centre. Our aim was to assess the feasibility of a trial of postpartum short‐term enoxaparin in Europe.Pragmatic, open‐label pilot randomised controlled trial (RCT).Swiss tertiary hospital.Postpartum women, within 48 h of delivery, deemed at intermediate risk of VTE with at least one major risk factor (morbid obesity, thrombophilia, emergency caesarean section, pre‐eclampsia, preterm delivery, intrauterine growth restriction or systemic peripartum infection) and/or at least two minor risk factors.Participants were randomised to enoxaparin 40–60 mg once daily for 10 days or no treatment, with a 90‐day follow‐up.Participation rate and study acceptance (randomised participants among women in whom informed consent was sought).Recruitment was open for 25 weeks in 2022. Among 1504 postpartum women, 480 were eligible and 77 were randomised. The recruitment rate was 3.1 per week (13.3 per month) and the study acceptance was 23.8%. At 3 months, there was no VTE event, but one major, one nonmajor obstetrical bleeding and one surgical site complication, all in the enoxaparin group.This pilot RCT of postpartum thromboprophylaxis set in Switzerland yielded greater participation rate and acceptance than previous attempts in North America. It calls for a large, international, collaborative trial to guide this important clinical decision.ClinicalTrial.gov identifier: NCT05878899 and NCT04153760. [ABSTRACT FROM AUTHOR]

One in five pregnant women has obesity in Europe. It is an independent risk factor for maternal and foetal complications during pregnancy and delivery, increasing linearly with pre-conceptional body mass index. Excessive gestational weight gain further aggravates these risks. The clinician should measure body weight at each visit from the 1st trimester of pregnancy, search and monitor complications and be aware of preventive measures. A balanced diet with low glycemic load and light to moderate physical activity 30‑60 minutes 3‑5 times per week should be recommended during pregnancy and postpartum to control gestational weight gain and reduce the risks of short and long-term maternal and infant complications., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.