Could a pill replace daily shots for clot prevention after C-Section?

NCT ID NCT07820670

Prevention Sponsor: Wolfson Medical Center Source: ClinicalTrials.gov ↗

First seen Sep 15, 2026 · Last updated Sep 16, 2026 · Updated 1 time

Summary

After a cesarean section, women face a higher risk of dangerous blood clots, and doctors often prescribe enoxaparin, a blood thinner given by daily injection. This trial compares enoxaparin with rivaroxaban, an oral blood thinner taken once a day, in 62 women who have an elective cesarean and meet criteria for in-hospital clot prevention. Researchers will draw blood on the second day after surgery to measure clotting activity and drug levels, and ask participants about their satisfaction with the treatment. The goal is to see whether the two drugs produce similar laboratory anticoagulant effects.

What this could mean

Our plain-language read of the trial. This is informational only, not medical advice or a prediction.

Active substance: rivaroxaban, an oral blood thinner, compared with enoxaparin, an injected blood thinner
What this could lead to: If rivaroxaban matches enoxaparin in these lab tests, it could offer women a once-daily pill instead of daily injections to prevent clots after cesarean section.
What could go wrong: This is a small, single-center study of 62 women that measures lab clotting markers, not actual clot rates, so it cannot prove either drug prevents clots better. Rivaroxaban carries bleeding risks and is not routinely used in breastfeeding or postpartum women without more safety data.

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Study facts

What this study's own registry entry says, in plain language.

Phase

Not a phased trial

Phase numbers describe drug development. The registry uses this when they do not apply, as it does for trials of devices, procedures or behaviour changes, and for observational studies.

Participants

About 62 people

The number the study aims to enrol. It can still change while the study runs.

Started

Dec 2025

Expected to finish

Dec 2027

An estimate. End dates often move.

Lead sponsor

A government agency

The lead sponsor is a government body.

Who can take part

This study's own entry requirements. Only the study team can say for certain whether you qualify.

Ages

18 to 50 years

Sex

Female participants only

Healthy volunteers

Not accepted

This study is not open to healthy volunteers. The entry requirements below say who it is open to.

Show the full entry requirements

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Hebrew-speaking women * age 18-50 * Elective cesarean at Wolfson * Indicated for in-hospital thromboprophylaxis per local protocol (need ≥2 risk factors among: cesarean delivery; age \>35; BMI \>30; parity ≥3; labor duration ≥12 h; postpartum hemorrhage or blood transfusion; reduced mobility) Exclusion Criteria: * Known thrombophilia * Prior arterial/venous thrombosis * Creatinine clearance \<29 mL/min * Abnormal liver enzymes/bilirubin or liver disease * Coagulation disorders * Platelets \<75,000/mm³ * Interacting drugs affecting DOAC metabolism (e.g., strong CYP3A4/P-gp modulators; azoles; protease inhibitors; rifampicin; phenytoin; carbamazepine; phenobarbital; St. John's wort; dronedarone) * Active bleeding or contraindication to anticoagulation * Peptic disease/GI bleeding history * Hemoptysis risk/history * Preeclampsia * Active infection * Significant lower-limb varicosities * Need for prophylaxis beyond discharge (≥3 risk factors) * Maternal weight \<50 kg or \>100 kg

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Conditions

The condition(s) this trial relates to.

venous thromboembolism prevention target

As listed by the trial registrant

The condition terms exactly as the trial's registrant entered them.

Cesarean section surgery Postpartum period Vte (venous thromboembolism)

How to take part

Only the study team decides who joins. These are the ways to reach them.

The places running it

1 site. The list below names each one and where it is.
The official record

ClinicalTrials.gov lists the study team's own contact details, including names and phone numbers. We don't republish those.

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A doctor treating you

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Could a pill replace daily shots for clot prevention after C-Section?

What the study statuses mean