The local literature lacks comprehensive information regarding the actual incidence of intrauterine growth restriction (IUGR) and oligohydramnios and currently available therapeutic options. Therefore, the current study was planned with the objective to evaluate the impact of enoxaparin therapy compared with standard management on neonatal outcomes in pregnancies complicated by intrauterine growth restriction (IUGR) with oligohydramnios.

The use of enoxaparin is not yet a standard practice in pregnancies with IUGR and oligohydramnios without overt maternal thrombophilia. Given the notable incidence of IUGR and oligohydramnios and the limited therapeutic options currently available, exploring the potential benefits of enoxaparin therapy against standard management is both clinically and socially relevant. By investigating whether enoxaparin can improve fetal outcomes in this high-risk group, the findings of this study would generate evidence that could inform future management protocols, reduce preventable perinatal morbidity and mortality, and ultimately improve neonatal survival and health in Pakistan.

Inclusion Criteria:

• Women aged 18-40 years
• Singleton pregnancy
• Gestational age ≥28 weeks (confirmed by first-trimester scan or reliable last menstrual period)
• Diagnosed with both IUGR and oligohydramnios
• Willing to provide informed written consent

Exclusion Criteria:

• Multiple gestation
• Major fetal congenital anomalies
• Maternal medical disorders affecting pregnancy outcome (e.g., uncontrolled diabetes, chronic hypertension, renal disease)
• Known coagulation disorders or contraindications to enoxaparin
• Women already on anticoagulation therapy.

Data can be shared on a reasonable request.